Search

Background: The ideal nutritive strategy for a neonate with congenital diaphragmatic hernia (CDH) has not been elucidated. The purpose of this study was to investigate the efficacy of early parenteral nutrition (PN) in CDH neonates. Methods: Thirty‐five CDH neonates admitted to a single hospital from January 2005 to December 2014 were retrospectively reviewed. For the first 4 years of the study period, neonates received non‐early PN (n‐EPN) (2005–2008, amino acids [AA] <1.0 g/kg/day, no lipids administered). After the transitional period (TP) (2009–2011, AA 1.0–2.5 g/kg/day, lipid 1.0 g/kg/day), early PN (EPN) (2011–2014, AA ≥3.0 g/kg/day, lipid 1.0 g/kg/day) was performed. We investigated the clinical effect of PN for growth‐associated clinical variables and the outcomes. Results: The first day of AA administration was late in the n‐EPN period (6.0 ± 4.6, 0.0 ± 0.8, 0.1 ± 0.3 ; n‐EPN, TP, EPN: in order). The final day of PN (11.0 ± 3.7, 9.2 ± 4.0, 12.4 ± 3.9) and the first day of enteral feeding (4.5 ± 1.9, 4.3 ± 1.4, 4.5 ± 3.2), the first day of full milk feeding (100 mL/kg/day) (10.8 ± 5.4, 9.2 ± 2.3, 11.5 ± 3.5) were statistically equal in every period. The date and body weight at discharge showed no significant differences among the three groups, but the weight‐gain rate from birth to discharge was higher in the EPN group than in the n‐EPN group (P = 0.023). The rate of inhaled nitric oxide (NO) gas administration and the duration of ventilation showed no significant differences among the three groups. Severe PN‐associated liver disease was not noted during the observation period. Conclusions: Early PN for CDH neonates promotes weight gain in the neonatal intensive‐care unit. The long‐term efficacy and safety of EPN for CDH neonates should be elucidated by additional studies. [ABSTRACT FROM AUTHOR]