TY - JOUR
T1 - Impact of nutrition in the treatment of congenital diaphragmatic hernia
AU - Terui, Keita
AU - Usui, Noriaki
AU - Tazuke, Yuko
AU - Nagata, Kouji
AU - Ito, Miharu
AU - Okuyama, Hiroomi
AU - Hayakawa, Masahiro
AU - Taguchi, Tomoaki
AU - Sato, Yasunori
AU - Yoshida, Hideo
N1 - Funding Information:
This work was supported by a grant from the Ministry of Health, Labour and Welfare of Japan [grant number H24-Nan-chi-Ippan-034, 2002].
Publisher Copyright:
© 2019 Japan Pediatric Society
PY - 2019/5
Y1 - 2019/5
N2 - Background: The optimum enteral (EN) and parenteral nutrition (PN) regimens during acute management of congenital diaphragmatic hernia (CDH) remain unclear. We examined the effects of EN and PN on weight gain in CDH patients. Methods: A multicenter retrospective cohort study of neonates with CDH (born 2006–2010; n = 105) who survived to discharge was conducted. Patients were divided as receiving PN ≥ or <50 kcal/kg/day at 1 week of age, and EN ≥ or <60 kcal/kg/day at 2 weeks of age. Changes in bodyweight at 30, 60, and 90 days of age were compared. Results: The higher EN group (n = 39) had greater mean weight gain than the lower EN group (n = 66; 90 days: 2,501 g, 95% CI: 2,294–2,710 g vs 1,706 g, 95% CI: 1,553–1,861 g; P <0.001). When patients received lower EN, the higher PN group (n = 24) had greater mean weight gain than the lower PN group (n = 42; 90 days: 1,768 g, 95% CI: 1,574–1,961 g vs 1,411 g, 95% CI: 1,264–1,558 g; P = 0.004). Conclusion: The amount of EN in the acute phase of CDH management is essential for weight gain during infancy. When patients are intolerant to adequate EN, supportive PN is also essential.
AB - Background: The optimum enteral (EN) and parenteral nutrition (PN) regimens during acute management of congenital diaphragmatic hernia (CDH) remain unclear. We examined the effects of EN and PN on weight gain in CDH patients. Methods: A multicenter retrospective cohort study of neonates with CDH (born 2006–2010; n = 105) who survived to discharge was conducted. Patients were divided as receiving PN ≥ or <50 kcal/kg/day at 1 week of age, and EN ≥ or <60 kcal/kg/day at 2 weeks of age. Changes in bodyweight at 30, 60, and 90 days of age were compared. Results: The higher EN group (n = 39) had greater mean weight gain than the lower EN group (n = 66; 90 days: 2,501 g, 95% CI: 2,294–2,710 g vs 1,706 g, 95% CI: 1,553–1,861 g; P <0.001). When patients received lower EN, the higher PN group (n = 24) had greater mean weight gain than the lower PN group (n = 42; 90 days: 1,768 g, 95% CI: 1,574–1,961 g vs 1,411 g, 95% CI: 1,264–1,558 g; P = 0.004). Conclusion: The amount of EN in the acute phase of CDH management is essential for weight gain during infancy. When patients are intolerant to adequate EN, supportive PN is also essential.
KW - enteral nutrition
KW - neonatal care
KW - neonatal intensive care
KW - neonatal surgery
KW - parenteral nutrition
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U2 - 10.1111/ped.13837
DO - 10.1111/ped.13837
M3 - Article
C2 - 30888699
AN - SCOPUS:85065990740
SN - 1328-8067
VL - 61
SP - 482
EP - 488
JO - Pediatrics International
JF - Pediatrics International
IS - 5
ER -