Effects of amino acid initial high dose and rapid increase scheme on premature infants feeding tolerance and safety

ZHANG Xueming; HE Haiying; YAN Mengqiu

doi:10.3969/j.issn.1002-7386.2018.02.010

Abstract：Objective To investigate the effects of amino acid initial high dose and rapid increase scheme on premature infants feeding tolerance and safety.Methods Seventy-six premature infants were randomly divided into observation group (n =38) and control group (n =38).The patients in observation group were treated by amino acid initial high dose intervention,with initial dosage being 3g · kg-1 · d-1,which was increased progressively,at 0.5g · kg-1 · d-1,and prediction dose was 4.0g · kg-1 · d-1,however,the patients in control group were treated by amino acid rapid increase scheme,with initial dosage being 1.5g · kg-1 · d-1,which was increased progressively at 1.0g · kg-1 · d-1,and prediction dose was 4.0g · kg-1 · d-1.After treatment the growth and development indexes,related blood gas indexes,biochemical indexes and immune function at birth,one week after delivery were observed and compared between two groups.Moreover the feeding tolerance rate and complications were also observed and compared between two groups.Results In the aspect of growth and development indexes,there were significant differences in weight descent percentage and recovery time of body weight between two groups (P ＜ 0.05).The parenteral nutrition time and hospitalization time in observation group were significantly shorter than those in control group (P ＜ 0.05).In the aspect of blood gas and biochemical indexes,there were significant differences in albumin,BUN and base excess in both groups between one week before birth and at birth (P ＜ 0.05),moreover,which in observation group were superior to those in control group (P ＜ 0.05).In the aspect of immune function,there were significant differences in CD3+,CD4+,CD8+ between two groups (P ＜ 0.05).In addition the feeding tolerance rate in observation group was 94.74％,which was significantly higher than that (78.95 ％) in control group (P ＜ 0.05),however,there were no significant differences in incidence rates of complications including anemia and the other ones between the two groups (P ＞ 0.05).Conclusion As compared with rapid increase scheme,the amino acid initial high dose parenteral nutrition can effectively improve the nutritional status and immune function of premature infants,which is beneficial to the growth and development of neonates,and feeding tolerance rate is higher,with safety and feasibility.