Prematüre Bebeklerde Erken Agresif Total Parenteral Nütrisyonun Biyokimyasal Parametreler Üzerine Etkileri

Year 2019, Volume: 17 Issue: 3, 337 - 349, 02.12.2019

Hilal Özkan , Mehmet Fatih Başak Nilgün Köksal Bayram Dorum Salih Çağrı Çakır

Abstract

GİRİŞ ve AMAÇ: Prematüre bebeklerde yüksek
miktarda proteinin ilk gün başlanması ile büyüme ve nöromotor gelişimin olumlu
etkilendiği bildirilmiştir. Ancak yüksek protein miktarının biyokimyasal
parametreler üzerine etkisi tam olarak bilinmemektedir. Bu çalışmada prematüre
bebeklerde düşük ve yüksek doz protein uygulamasının biyokimyasal parametreler
üzerine olan etkisinin araştırılması amaçlanmıştır.

 

YÖNTEM ve GEREÇLER: Bu retrospektif çalışmaya 34
hafta ve altında doğan prematüre bebekler dahil edildi. Olgular düşük (DP; ilk
gün 1 g/kg/gün, günlük 1 g arttırarak maksimum 3 g/kg/gün) ve yüksek protein
(YP; ilk gün 3 g/kg/gün, maksimum 3,5-4 g/kg/gün) alımlarına göre iki gruba
ayrılarak antenatal ve postanatal özellikler, biyokimyasal sonuçlar ve büyüme
gelişmeleri bakımından karşılaştırıldı.

 

BULGULAR: YP grubunda 264, DP grubunda 100
olmak üzere çalışmaya toplam 364 hasta alındı. Biyokimyasal belirteçler
bakımından gruplar karşılaştırıldığında; YP grubundaki olgularda kan üre azotu
değerlerinin, protein alımı ile korele olarak arttığı görüldü, ancak böbrek
fonksiyonlarında bozulma saptanmadı. Her iki grupta elektrolit bozukluğu
açısından anlamlı farklılık gözlenmedi. YP grubu ile karşılaştırıldığında, DP
grubunda ki olguların taburculuktaki ağırlık, boy ve baş çevresi
persentillerinin daha fazla oranda 3 persentilin altında olduğu saptandı.

 

TARTIŞMA ve SONUÇ: Bu çalışma ile yüksek protein
uygulamasının güvenli ve etkin olduğu gösterildi. Ayrıca postnatal büyüme
üzerine olan olumlu etkileri dikkate alındığında, beslenmenin ana hedefinin
sağlandığı gözlemlendi. 

Keywords

Prematürite, total parenteral nürtisyon

Effects of Early Aggressive Total Parenteral Nutrition on Biochemical Parameters Outcome in Preterm Infants

Abstract

INTRODUCTION: Initiation of high protein,
especially on the first day, was reported to positively affect growth and
neuromotor development in premature infants. However the effect of high protein
content on metabolic and biochemical parameters is unknown. The aim of this
study was to investigate the effects of low and high dose protein administration
on biochemical parameters in premature infants.

 

METHODS: Premature infants born ≤34
gestational weeks were included in this retrospective study. The infants were
divided into two groups as low protein (LP; first day of 1 g/kg/day, daily 1g
increments up to max. 3 g/kg/day) and high protein (HP; first day 3 g/kg/day,
max. 3,5-4 g/kg/day) and both groups were compared in terms of antenatal and
postanatal characteristics, biochemical results, and growth.

 

RESULTS: A total of 364 infants, 264 in
HP and 100 in LP groups, were included in this study. When the groups were
compared in terms of biochemical markers; blood urea nitrogen levels showed an
increase in HP group in correlation with protein intake, however, no
deterioration in renal functions occured. No electrolyte impairment was
observed between two groups. Compared with HP group, more number of infants in
LP group had weight, height, and head circumference of <3 percentile at the
time of hospital discharge

 

DISCUSSION
and CONCLUSION:
This study showed that high dose protein administration is safe and effective.
Furthermore, when considering the positive effects on postnatal growth, it was
observed that the main goal of the feeding was achieved. 

Keywords

Prematurity, total parenteral nutrition

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