An Adequate Increase in Incremental Feeding Rate May be Useful in Reducing the Incidence of Parenteral Nutrition-associated Cholestasis in Preterm Infants with Birthweight Less than ۱۵۰۰g

Background: Parenteral nutrition-associated cholestasis (PNAC) is one of the most challenging complications of prolonged parenteral nutrition (PN). Limited data are available regarding the association between enteral nutrition (EN) and PNAC. We aimed to explore the correlation of EN strategies with PNAC in preterm infants with birth weight less than ۱۵۰۰ g. Methods: A nested case-control study (۱:۱) was performed including infants with gestational age (GA) < ۳۷ weeks, birth weight (BW) < ۱۵۰۰ g, and duration of PN > ۷ days. GA, BW, and duration of PN were used as matching criteria. EN strategies before the onset of PNAC were described. Conditional logistic regression was used to identify the independent association of EN strategies with PNAC. Results: A total of ۶۶ subjects were studied. Univariate analysis revealed that incremental feeding rate, average feeding amounts, average caloric intake via the enteral route, episodes of EN interruption, and days to start EN were similar before the onset of PNAC between groups. Feeding amounts and caloric intake via the enteral route were also similar at the onset of PNAC between groups. On logistic regression, incremental feeding rate was negatively associated with PNAC (OR: ۰.۴۷۹, ۹۵% CI: ۰.۲۷۲-۰.۸۴۴, p=۰.۰۱۱). Conclusion: Incremental feeding rate may be associated with the development of PNAC in preterm infants. Our findings suggest that an adequate increase in incremental feeding rate may be useful in reducing the incidence of PNAC in preterm infants with birth weight less than ۱۵۰۰ g.

کلیدواژه ها:

enteral feeding advancement rates ، Enteral Nutrition ، extremely low birth weight infants ، Parenteral nutrition-associated cholestasis ، Very Low Birth Weight Infants