Journal of Developmental Medicine(Electronic Version)  2025, Vol. 13 Issue (4): 293-298,314 DOI: 10.3969/j.issn.2095-5340.2025.04.008 |
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| Construction and effect of nourishing enteral nutrition scheme during mild hypothermia treatment for severe hypoxic-ischemic encephalopathy in newborns |
| He Liu, Wang Zizhen, Ke Yan, et al
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(Department of Neonatology, Pediatric Medicine, the Seventh Medical Center of Chinese PLA General Hospital, Beijing 100700, China)
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Abstract 【Abstract】 Objective To establish a protocol for implementing nourishing enteral nutrition during hypothermia therapy in children with severe hypoxic-ischemic encephalopathy (HIE), and to explore its clinical safety and effectiveness. Method A retrospective analysis was conducted on 98 full-term neonates with severe hypoxic-ischemic encephalopathy (HIE) who underwent invasive ventilation, had nasogastrictubes in place, and received systemic hypothermia therapy in the Neonatal Intensive Care Unit of the Department of Pediatrics, Seventh Medical Center of Chinese PLA General Hospital, from January 2015 to December 2022. Among them, 48 cases admitted from January 2015 to June 2019 were assigned to the
control group, receiving routine care and fasting during hypothermia therapy; 50 cases admitted from July 2019 to December 2022 were assigned to the study group, on the basis of routine care, implementing a trophic enteral nutrition protocol constructed and developed with evidence-based support. Various indicators during hospitalization before and after the implementation of the protocol were compared between the two groups. The primary indicators were the incidence of feeding intolerance, including abdominal distension, gastric retention, vomiting, and bloody stools. The secondary indicators included nutritional status (body weight, serum albumin, total protein, duration of parenteral nutrition, incidence of hypoglycemia) on the 1st, 7th, and 14th days of admission, and efficacy indicators (duration of invasive ventilation therapy, average length of hospital stay). Statistical analysis performed by t-test and Fisher's exact probability method. Result
In terms of the incidence of feeding intolerance, the incidences of abdominal distension (0 vs 20.8%), gastric retention (0 vs 10.4%), vomiting (8% vs 31.2%), and bloody stools (2% vs 8.3%) were compared between the study group and the control group, and the differences were statistically significant (all P<0.05). In terms of nutritional status, the body weight of the study group was higher than that of the control group on the 14th day of admission, with a statistically significant difference (P<0.05). The serum albumin and total protein of the study group were better than those of the control group on the 14th day of admission, with statistically significant differences (P<0.01). The average duration of parenteral nutrition therapy in the study group and the control group was (7.02±1.60) days vs (12.69±2.52) days, and the incidence of hypoglycemia was 0 vs
10.4%, with statistically significant differences (all P<0.05). In terms of other efficacy indicators, the average duration of invasive ventilation therapy in the study group was (5.08±1.37) days vs (7.77±1.67) days, and the average length of hospital stay was (12.72±1.79) days vs (17.00±2.45) days, both of which were lower than those in the control group, with statistically significant differences (all P<0.001). Conclusion The nourishing enteral nutrition protocol developed for neonates with severe HIE during systemic hypothermia therapy is safe and feasible. It not only reduces the incidence of feeding intolerance and hypoglycemia during hospitalization but also helps improve the nutritional status of neonates, shortens the duration of parenteral nutrition, invasive ventilation, and hospital stay, thereby promoting neonates' recovery. It is worthy of clinical
promotion
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Received: 19 July 2024
Published: 31 July 2025
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