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Induction of early meconium evacuation promotes feeding tolerance in very low birth weight infants

Cited 23 time in Web of Science Cited 29 time in Scopus
Authors
Shim, So-Yeon; Kim, Han-Suk; Kim, Do-Hyun; Kim, Ee-Kyung; Son, Dong Woo; Kim, Beyong Il; Choi, Jung-Hwan
Issue Date
2007
Publisher
Karger
Citation
Neonatology 2007;92:67-72
Keywords
Enema/adverse effects/*methodsEnteral Nutrition/*methodsGastrointestinal Motility/drug effects/physiologyGlycerol/*therapeutic useHumansInfant, Newborn/*metabolismInfant, Very Low Birth Weight/*metabolismMeconium/*metabolismTreatment Outcome
Abstract
BACKGROUND: A delay in reaching full enteral feeding is linked to poorer outcome in preterm neonates. Meconium retention has been viewed as a cause of bowel dysfunction in very low birth weight infants (VLBWI). Thus, adequate evacuation of meconium could help to promote feeding tolerance. OBJECTIVES: Our goal was to determine the effect of the induction of early meconium evacuation on feeding tolerance in VLBWI. METHODS: An observational study involving two subsequent periods was performed in inborn infants with birth weights of <1,500 g, before (control) and after (study) the induction of early meconium evacuation by routine glycerin enema. The total duration of these periods was from January 2003 to December 2005. To evaluate feeding tolerance, we measured time to achieve full enteral feeding. Complications such as sepsis and necrotizing enterocolitis were compared. RESULTS: The study group achieved full enteral feeding significantly faster than the control group (hazard ratio (HR) = 2.9; 95% confidence interval (CI) = 1.8-4.8), and this effect was more definite in infants with a birth weight of <1,000 g (HR = 4.6; 95% CI = 1.9-11.1). The study group passed first meconium faster than the control group (median = 1.4 vs. 3.7 days; p < 0.001). Sepsis, especially as determined by positive culture in central venouscatheter, was significantly reduced in the study group (7.7 vs. 27.8%; p = 0.02). CONCLUSIONS: The induction of early meconium evacuation had a significantly positive effect on feeding tolerance and sepsis prevention in VLBWI.
ISSN
1661-7800 (Print)
Language
English
URI
http://content.karger.com/produktedb/produkte.asp?typ=pdf&file=000100804

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17356305

http://hdl.handle.net/10371/23186
DOI
https://doi.org/10.1159/000100804
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College of Medicine/School of Medicine (의과대학/대학원)Pediatrics (소아과학전공)Journal Papers (저널논문_소아과학전공)
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