• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.545-553
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• 2019

Purpose: Feeding tolerance is extremely important in preterm infants. This study aimed to evaluate whether preterm infants receiving Lactobacillus reuteri DSM 17938 would develop fewer symptoms of feeding intolerance. Secondary outcomes were duration of parenteral nutrition, time to reach full feeding, length of hospital stay, sepsis, necrotizing enterocolitis (NEC), diarrhea, and mortality. Methods: This double-blind randomized controlled trial of L. reuteri DSM 17938 versus placebo included 94 neonates with a gestational age of 28-34 weeks and birth weight of 1,000-1,800 g. Results: Feeding intolerance (vomiting and/or distension) was less common in the probiotic group than in the placebo group (8.5% vs. 25.5%; relative risk, 0.33; 95% confidence interval, 0.12-0.96; p=0.03). No significant intergroup differences were found in proven sepsis, time to reach full feeding, length of hospital stay, or diarrhea. The prevalence of NEC (stages 2 and 3) was 6.4% in the placebo group vs. 0% in the probiotic group (relative risk, 1.07; 95% confidence interval, 0.99-1.15; p=0.24). Mortality rates were 2.1% in the probiotic group and 8.5% in the placebo group, p=0.36). Conclusion: The administration of L. reuteri DSM 17938 to preterm infants was safe and significantly reduced feeding intolerance. No significant differences were found in any other secondary outcomes.

• Child Health Nursing Research
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• 제22권4호
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• pp.355-362
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• 2016

Purpose: The purpose of this study was to identify effects of Massage therapy on feeding intolerance and physical growth in premature infants. Methods: This study was conducted in the NICU of U university hospital, from June to December 2014. A quasi experimental design was used. A total of 60 premature infants were randomly assigned into two groups of 30 infants each. Infants of control group were given conventional treatment, while infants of experimental group given conventional treatment plus massage therapy. Massage therapy was performed for 15 minutes, 60 min before feeding, 3 times per day for 21 times over 7 days. The number of feedings withheld for feeding intolerance, number of gastric residuals, number of fecal excretions and physical growth variables (weight, height) were measured. Results: After the intervention, number of fecal excretions and weight gain in the experimental group were significantly higher than that of the control group. Also, number of gastric residuals in the experimental group was lower than that of the control group. Conclusion: Massage therapy laid the basis for nursing intervention to promote feeding tolerance and physical growth in premature infants.

• Neonatal Medicine
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• 제18권2호
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• pp.204-210
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• 2011

목적: 극소 저체중 출생아에서 식이 불내성은 매우 흔하나, 괴사성 장염 외에는 원인에 대한 연구가 미흡하다. 본 연구기관에서는 식이 불내성이 지속되는 극소 저체중 출생아 중 알레르기성 장염을 의심하여 치료한 경험이 있어 이의 임상상을 분석하고자 하였다. 방법: 2009년 1월부터 2010년 7월까지 삼성서울병원 신생아 중환자실에 입원하였던 출생 체중 1,500 g 미만의 미숙아들 중에 식이 불내성을 보이고, 말초혈액 검사상 중등도 이상의 호산구증(${\geq}$1,000 cells/$mm^3$)이 동반되는 경우에 신생아 괴사성 장염이 배제된 상태에서 식이 제한 모유 혹은 가수 분해 분유에 반응하였던 경우들을 조사하였다. 결과: 연구대상 181명 중에서 식이 불내성을 나타낸 환자는 총 161명(88.9%), 호산구 증가증을 나타낸 환자는 119명(65.7%), 중등도 이상의 호산구 증가증을 나타낸 환자는 85명으로 47%의 유병률을 보였다. 알레르기성 장염으로 진단받은 환자는 17명으로 9.4%의 유병률을 보였다. 식이 불내성 환자 중 알레르기성 장염군(n=17)과 비알레르기성 장염군(n=144)과의 비교에서 평균 재태 주수, 출생 체중, 입원 기간, 항생제 사용 기간, 증상 발생일, 정맥 영양 기간은 차이가 없었으나, 최대 호산구 %의 평균값은 두 질환군에서 통계학적으로 유의하게 차이가 있었다. 알레르기성 장염으로 진단 받은 환자들 중 식이 제한모유로 2명인 12%에서 증상의 호전을 보였고, Extensively hydrolyzed formula로 10명(59%)에서 증상의 호전을 보였다. Free amino acid-based formula로 5명(29%)에서 증상의 호전을 보였다. 결론: 극소 저체중 출생아에서 식이 불내성이 있는 경우 알레르기성 장염의 가능성을 고려할 수 있고 이 경우 식이 변경을 통해 적극적인 식이 진행이 가능하였다.

• Child Health Nursing Research
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• 제22권2호
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• pp.79-86
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• 2016

Purpose: The purpose of this study was to identify breastfeeding practice with late preterm infants (LPIs), and to determine predictors of exclusive breastfeeding at the 12th week after discharge. Methods: The participants were 106 mothers of LPIs hospitalized in neonatal intensive care units at two university hospitals. Data were collected between February and October, 2013. Questionnaires included characteristics of LPIs, their mothers, and feeding-related characteristics. Feeding methods were exclusive breastfeeding, mixed feeding, and formula feeding. Results: Exclusive breastfeeding steadily increased from 5.7% at the 1st week to 19.8% at the 12th week, as did formula feeding from 27.3% to 67.9%. Contrarily, mixed feeding decreased from 67.0% at the 1st week to 12.3% at the 12th week. The ratio of formula feeding was higher than that of exclusive breastfeeding over time. Predictors for exclusive breastfeeding were the following: type of delivery (OR=2.96, 95%CI=1.07-8.14), feeding intolerance (OR=3.03, 95%CI=1.26-7.25) and feeding method during hospitalization (OR=7.84, 95%CI=3.15-19.53). Conclusion: In order to increase breastfeeding opportunities for LPIs, educational programs for gestational age-appropriate breastfeeding should be developed. The focus of breastfeeding education needs to be on mothers who delivered their LPIs through Cesarean-section and LPIs who had feeding intolerance or were fed only formula during hospitalization.

• 대한임상독성학회지
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• 제22권1호
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• pp.1-9
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• 2024

Purpose: Nutritional therapy is a crucial component of therapy for critically ill patients, but there is a lack of nutritional support guidelines for organophosphate (OP) poisoning, likely due to the gastrointestinal effects of atropine, the main antidote for OP. This study investigated whether enteral nutrition (EN) during atropinization is acceptable for mechanically ventilated patients after OP poisoning. Methods: This retrospective study classified 82 patients with OP poisoning according to whether they were fed during atropinization while on mechanical ventilation (MV). Data on the baseline characteristics, nutritional support, and clinical outcomes were compared. Univariate and multivariate regression models were constructed to analyze the associations between atropine administration for OP poisoning and feeding intolerance-related EN after adjustment for risk factors. Results: Eighty-two patients received EN after 72 hours on MV, and 40 of them simultaneously received 2 mg/hr atropine for the first 120 hours after EN initiation. The overall incidence of feeding intolerance was 57.3% during the first 12 days after EN initiation and did not differ according to atropine administration. Appropriate atropinization during EN in regression model 1 and the dosage of atropine administered during EN and the duration of EN during atropinization in model 2 were not associated with feeding intolerance in patients on MV after OP poisoning. Conclusion: Appropriate atropinization is not associated with feeding intolerance after EN provision in patients on MV after OP poisoning. This study will help establish nutritional guidelines for OP poisoning patients. More research on nutritional support is needed to validate our results.

• 중환자간호학회지
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• 제12권3호
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• pp.74-83
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• 2019

Purpose : The routine evaluation of gastric residuals (RGR) is considered standard care for premature infants. This study evaluated the usefulness of RGR in premature infants. Methods : The study retrospectively investigated 208 premature infants (gestational aged under 34 weeks) who underwent gavage feeding in a neonatal intensive care unit at a tertiary hospital. The patients were divided into two groups: RGR (n=104) and no-RGR (n=104). Those in the no-RGR group had their gastric residuals checked only if signs of feeding intolerance were present. Clinical outcomes, including the time to reach full enteral feeding (FEF) and the incidences of gastrointestinal disorders such as feeding intolerance (FI) and necrotizing enterocolitis (NEC), were compared. Data were analyzed with SPSS ver. 21, using a Mann-Whitney U test, chi-squared test, and Fisher's exact test. Results : There was no statistically significant difference for the time to FEF (z=-0.61, p=.541), incidence of FI ($X^2=0.38$, p=.540), and NEC ($X^2=1.42$, p=.234) between the two groups. Conclusion : No-RGR did not increase the risk for FI or NEC. These results suggest that RGR evaluation may not improve nutritional outcomes in premature infants. Recommendations for further research and practice guidelines will be provided.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권3호
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• pp.189-195
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• 2018

Purpose: We investigated fecal calprotectin (FC) levels in preterm infants with and without feeding intolerance (FI), and compared the FC levels according to the type of feeding. Methods: The medical records of 67 premature infants were reviewed retrospectively. The fully enteral-fed infants were classified into two groups; the FI group (29 infants) and the control group (31 infants). Seven infants with necrotizing enterocolitis, sepsis, and perinatal asphyxia were excluded. If breast milk (BM) or preterm formula (PF) could not be tolerated by infants with FI, amino acid-based formula (AAF) was tried temporarily. Once FI improved, AAF was discontinued, and BM or PF was resumed. We investigated the FC levels according to the type of feeding. Results: Significant differences were found in gestational age, birth weight, age when full enteral feeding was achieved, and hospital stay between the FI and control group (p<0.05). The FC levels in the FI group were significantly higher than those in the control group (p<0.05). The FC levels in the AAF-fed infants with FI were significantly lower than those in the BM- or PF-fed infants (p<0.05). The growth velocities (g/d) and z scores were not significantly different between the FI and control group (p>0.05). Conclusion: The FC levels in AAF-fed infants with FI showed significantly lower than those in the BM- or PF-fed infants with FI. The mitigation of gut inflammation through the decrease of FC levels in AAF-fed infants with FI could be presumed.

• Clinical and Experimental Pediatrics
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• 제53권1호
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• pp.7-13
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• 2010

Early nutritional support for preterm infants is critical because such support influences long-term outcome. Minimal enteral feeding should be initiated as soon as possible if an infant is stable and if feeding advancement is recommended as relevant to the clinical course. Maternal milk is the gold standard for enteral feeding, but fortification may be needed to achieve optimal growth in a rapidly growing premature infant. Erythromycin may aid in promoting gastrointestinal motility in cases that exhibit feeding intolerance. Selected preterm infants need vitamins, mineral supplements, and calorie enhancers to meet their nutritional needs. Despite all that is known about this topic, additional research is needed to guide postdischarge nutrition of preterm infants in order to maintain optimal growth and neurodevelopment.

• Neonatal Medicine
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• 제18권1호
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• pp.130-136
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• 2011

목적: Chloral hydrate는 검사 시 진정 목적으로 흔히 사용하는 약물이나 신생아에 관해서는 충분한 연구가 이루어지지 않고 있다. 이에 저자들은 신생아중환자실에서 chloral hydrate의 사용 시에 나타나는 부작용의 빈도와 그에 영향을 미치는 요소에 대해 알아보고자 한다. 또한 chloral hydrate만으로 진정이 되지 않아 추가 약물을 투여하는 경우 부작용이 증가하는지에 관해 알아보고자 한다. 방법: 2010년 3월부터 2011년 2월까지 가톨릭대학교 서울성모병원 신생아중환자실에서 검사 시 진정 목적으로 chloral hydrate를 사용한 104명을 대상으로 의무기록을 후향적으로 조사하였다. 결과: Chloral hydrate 투여 시 부작용은 41.3%에서 나타났으며 산소 포화도 감소(18.8%), 무호흡 증가(17.5%), 서맥 증가(10%), 수유량 감소(3.8%)가 있었다. Chloral hydrate 투여 시부작용은 chloral hydrate 투여 시기에 산소 투여 여부와 관련이 있었다(odds ratio [OR], 10.911: 95% confidence interval [CI], 2.082-57.178). 추가 약물 투여는 chloral hydrate 투여 시 산소 투여 여부와 관련이 있었고(OR, 4.151: 95% CI, 1.455-11.840) chloral hydrate 단독 투여 군에 비해 수유량 감소를 제외하고는 부작용에 유의한 차이가 없었다. 결론: 진정 요법이 필요한 검사 시 산소를 투여하고 있는 신생아에서 chloral hydrate의 사용은 부작용이 나타날 가능성이 높고 추가 약물 투여의 가능성이 높다. 추가 약물 투여가 필요한 경우에는 진정 유도 후 나타나는 수유량 감소에 주의하면서 진정을 유도할 수 있겠다.

• Preventive Nutrition and Food Science
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• 제19권3호
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• pp.164-169
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• 2014

The purpose of the present study was to investigate the short-term effects of a 12-day, soft pellet (SP) diet with a 3-h restricted feeding schedule on caloric intake, body weight, lipid metabolism, and insulin sensitivity. Glucose and insulin levels were measured pre-, mid-, and post-feeding. The SP rats exhibited postprandial hyperglycemia compared to rats fed control pellets (CP). The insulin response of SP rats during a meal was significantly higher than that of CP rats. There were no significant differences in the hepatic triacylglycerol contents and lipogenesis gene mRNA levels of SP and CP rats. However, the hepatocytes of SP rats were slightly hypertrophic. In addition, histological analysis revealed that the pancreases of SP rats had more islet areas than those of CP rats. This study demonstrated that feeding an SP-only diet for 12 days induces glucose intolerance, suggesting that the consumption of absorbable food, like a soft diet, may trigger glucose metabolism insufficiency and lead to life-threatening diseases.