Effect of enteral administration of insulın on establishment feeding tolerance in preterm infants

Giriş

To determine the effect of enteral administration of insulin on the establishment of enteral feeding in preterm infants <32 weeks gestation. insulin is present in maternal milk at levels three to fourfold higher than in maternal blood. insulin has been shown both in vitro and in vivo to accelerate a number of Gl functions.

Yöntem

A prospective, double blind, randomised, placebo controlled study was conducted on 60 preterm infants (<32 weeks gestation, < 1500 g) consecutively admitted to our neonatal intensive care unit. 30 preterm infants were given 0,5U/kg every six hours insulin enterally from 4 to 28 days of age. Feed toleration and time taken to establish full enteral feeding compared between the two groups. Parenteral nutrition was used until the infants achieved complete enteral feeds, and was adjusted to provide a total intake (enteral and parenteral) of 120 kcal/kg/day. Gastric residuals (>50% of a three hour feeding volume) were determined by aspiration of the gastric contents every three hours in ali infants. Doppler ultrasound blood flow velocity in the superior mesenteric artery (SMA) was determined before and after feeding. Serum glucose concentrations were measured at 0, 30, and 90 minutes after the first second and fifth doses of insulin.

Bulgular

 The times taken to establish full enteral feeding were significantly shorter (>30%) in the group receiving enteral insulin than in those receiving the placebo, fewer gastric residuals per infant and significantly increase in Doppler ultrasound blood flow velocity (>15%) in SMA after feeding. No adverse effects, such as hypoglycaemia, were observed after administration insulin.
The results suggest that enteral administration of insulin to preterm infants enhances GI funelion.

Anahtar Kelimeler

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