Clinical Experience in Enteral Nutrition Support for Premature Infants With Bronchopulmonary Dysplasia

Puangco, Maria A; Schanler, Richard J.

doi:10.1038/sj.jp.7200317

Cited by 13 publications

(12 citation statements)

References 18 publications

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“…This suboptimal energy intake is a major factor contributing to growth impairment and alterations in body composition in infants with BPD (Kurzner et al, 1988;Tammela et al, 1992;Huysman et al, 2003). About 82-91 kcal/100 ml may be necessary for lung repair and adequate growth in infants with BPD, but approximately 98 kcal/100 ml may be needed when fluid intake is restricted to p130 ml/kg/day (Puangco and Schanler, 2000). This represents a significant additional energy requirement above that delivered by human milk or by most of standard preterm formulas (Thureen and Hay, 1993;Puangco and Schanler, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…About 82-91 kcal/100 ml may be necessary for lung repair and adequate growth in infants with BPD, but approximately 98 kcal/100 ml may be needed when fluid intake is restricted to p130 ml/kg/day (Puangco and Schanler, 2000). This represents a significant additional energy requirement above that delivered by human milk or by most of standard preterm formulas (Thureen and Hay, 1993;Puangco and Schanler, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…The practice of simply concentrating standard formulas may involve several risks, including increased incidence of nausea, vomiting, diarrhea, and gastroesophageal reflux due to high osmolality feedings (Sutphen and Dillard, 1989;Salvia et al, 2001), nitrogen and other solute overload and insufficient water for growth (Pereira et al, 1994), hypertonic dehydration by exceeding the potential renal solute load (Ziegler and Fomon, 1989), and excessive mineral intake predisposing to nephrocalcinosis (Puangco and Schanler, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…In infants with BPD submitted to fluid restriction it may be difficult to meet the requirements to promote growth even by using standard preterm formulas containing a relatively high caloric density (Raffles et al, 1983;Puangco and Schanler, 2000). The use of formulas with added nonprotein energy supplements, such as glucose polymers (GP) and/or medium-chain triglycerides (MCT), is a possible strategy to provide hypercaloric low-volume feedings (Raffles et al, 1983;Thureen and Hay, 1993;Puangco and Schanler, 2000;Romera et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…The use of formulas with added nonprotein energy supplements, such as glucose polymers (GP) and/or medium-chain triglycerides (MCT), is a possible strategy to provide hypercaloric low-volume feedings (Raffles et al, 1983;Thureen and Hay, 1993;Puangco and Schanler, 2000;Romera et al, 2004). Supplementing standard formulas (Raffles et al, 1983;Puangco and Schanler, 2000) or breast milk (De Curtis et al, 1999;Fenton and Belik, 2002) by adding GP increases the osmolality of the feeds. Hyperosmolar feeds have been shown to empty from the stomach more slowly than isotonic solutions and are associated with an increased incidence of nausea, vomiting, diarrhea, and gastroesophageal reflux (Sutphen and Dillard, 1989;Salvia et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

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Osmolality of preterm formulas supplemented with nonprotein energy supplements

et al. 2007

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Background: Addition of energy supplements to preterm formulas is an optional strategy to increase the energy intake in infants requiring fluid restriction, in conditions like bronchopulmonary dysplasia. This strategy may lead to an undesirable increase in osmolality of feeds, the maximum recommended safe limit being 400 mOsm/kg. The aim of the study was to measure the changes in osmolality of several commercialized preterm formulas after addition of glucose polymers and medium-chain triglycerides. Methods: Osmolality was measured by the freezing point depression method. Six powdered formulas with concentrations of 14 g/100 ml and 16 g/100 ml, and five ready-to-feed liquid formulas were analyzed. All formulas, were supplemented with 10% (low supplementation) or 20% (high supplementation) of additional calories, respectively, in the form of glucose polymers and medium chain triglycerides, maintaining a 1:1 glucose:lipid calorie ratio. Inter-analysis and intra-analysis coefficients of variation of the measurements were always o 3.9%. Results: The mean osmolality (mOsm/kg) of the non-supplemented formulas varied between 268.5 and 315.3 mOsm/kg, increasing by 3-5% in low supplemented formulas, and by 6-10% in high supplemented formulas. None of the formulas analyzed exceeded 352.8 mOsm/kg. Conclusion: The supplementation of preterm formulas with nonprotein energy supplements with up to 20% additional calories did not exceed the maximum recommended osmolality for neonatal feedings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Osmolality of preterm formulas supplemented with nonprotein energy supplements

et al. 2007

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Growth and nutrition in children with established bronchopulmonary dysplasia: A review of the literature

et al. 2022

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Background Bronchopulmonary dysplasia (BPD) remains the most common late morbidity of preterm birth. Clinical care and research have largely focused on the pathogenesis and prevention of BPD. Preterm infants who develop BPD have significant medical needs that persist throughout their hospital course and continue after discharge, including those associated with growth and nutrition. The objective of this study was to review the available literature on nutrition and growth in infants with established BPD and to identify the knowledge and research gaps to provide direction for future studies. Methods We conducted a literature search in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines using Ovid MEDLINE, CINAHL, and Embase. Titles, abstracts, and full texts were independently reviewed by the authors and selected based on predetermined inclusion/exclusion criteria. Results were summarized qualitatively. Results Excluding duplicates, 2315 articles were identified. Thirty articles were selected for inclusion. We identified the following key components of nutrition support and clinical care: energy expenditure, growth, and metabolism; body composition; enteral nutrition; supplements; parenteral nutrition; and respiratory outcomes. Conclusions Despite a large body of literature describing the role of growth and nutrition in the prevention of BPD, research is lacking with respect to interventions and management in the population with established BPD. Thus, organized approaches for clinical interventions and trials with respect to growth and nutrition in infants and young children with established BPD are needed. These studies should include multiple centers because of the small numbers of patients with BPD at each site.

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Nutrition in Neonatal Pulmonary Disease

Cox

2013

Nutrition in Pediatric Pulmonary Disease

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Clinical Experience in Enteral Nutrition Support for Premature Infants With Bronchopulmonary Dysplasia

Cited by 13 publications

References 18 publications

Osmolality of preterm formulas supplemented with nonprotein energy supplements

Osmolality of preterm formulas supplemented with nonprotein energy supplements

Growth and nutrition in children with established bronchopulmonary dysplasia: A review of the literature

Nutrition in Neonatal Pulmonary Disease

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