Search

Your search keyword '"speed of increasing enteral nutrition"' showing total 2 results
Start Over Descriptor "speed of increasing enteral nutrition"
2 results on '"speed of increasing enteral nutrition"'

1. Nutritional strategies and gut microbiota composition as risk factors for necrotizing enterocolitis in very-preterm infants.

Author

Rozé, Jean-Christophe, Ancel, Pierre-Yves, Lepage, Patricia, Martin-Marchand, Laetitia, Nabhani, Ziad Al, Delannoy, Johanne, Picaud, Jean-Charles, Lapillonne, Alexandre, Aires, Julio, Durox, Mélanie, Darmaun, Dominique, Neu, Josef, and Butel, Marie-José

Subjects
PREMATURE infant nutrition, NEONATAL necrotizing enterocolitis, GUT microbiome, NEONATAL intensive care, PATHOLOGICAL physiology, PREMATURE infant diseases, BREASTFEEDING, RNA sequencing, DISEASE risk factors, PROBABILITY theory, CLINICAL trials, CLOSTRIDIUM, CONFIDENCE intervals, DECISION making, ENTERAL feeding, PREMATURE infants, INFANT nutrition, LONGITUDINAL method, MANAGEMENT, STAPHYLOCOCCUS, STATISTICAL significance, NEONATAL intensive care units, DESCRIPTIVE statistics, SEQUENCE analysis, ODDS ratio
Abstract

Background: The pathophysiology of necrotizing enterocolitis (NEC) remains poorly understood.Objective: We assessed the relation between feeding strategies, intestinal microbiota composition, and the development of NEC.Design: We performed a prospective nationwide population-based study, EPIPAGE 2 (Etude Epidémiologique sur les Petits Ages Gestationnels), including preterm infants born at <32 wk of gestation in France in 2011. From individual characteristics observed during the first week of life, we calculated a propensity score for the risk of NEC (Bell's stage 2 or 3) after day 7 of life. We analyzed the relation between neonatal intensive care unit (NICU) strategies concerning the rate of progression of enteral feeding, the direct-breastfeeding policy, and the onset of NEC using general linear mixed models to account for clustering by the NICU. An ancillary propensity-matched case-control study, EPIFLORE (Etude Epidémiologique de la flore), in 20 of the 64 NICUs, analyzed the intestinal microbiota by culture and 16S ribosomal RNA gene sequencing.Results: Among the 3161 enrolled preterm infants, 106 (3.4%; 95% CI: 2.8%, 4.0%) developed NEC. Individual characteristics were significantly associated with NEC. Slower and intermediate rates of progression of enteral feeding strategies were associated with a higher risk of NEC, with an adjusted OR of 2.3 (95% CI: 1.2, 4.5; P = 0.01) and 2.0 (95% CI: 1.1, 3.5; P = 0.02), respectively. Less favorable and intermediate direct-breastfeeding policies were associated with higher NEC risk as well, with an adjusted OR of 2.5 (95% CI: 1.1, 5.8; P = 0.03) and 2.3 (95% CI: 1.1, 4.8; P = 0.02), respectively. Microbiota analysis performed in 16 cases and 78 controls showed an association between Clostridium neonatale and Staphylococcus aureus with NEC (P = 0.001 and P = 0.002).Conclusions: A slow rate of progression of enteral feeding and a less favorable direct-breastfeeding policy are associated with an increased risk of developing NEC. For a given level of risk assessed by propensity score, colonization by C. neonatale and/or S. aureus is significantly associated with NEC. This trial (EPIFLORE study) was registered at clinicaltrials.gov as NCT01127698. [ABSTRACT FROM AUTHOR]

Published
2017
Full Text
View/download PDF

2. Nutritional strategies and gut microbiota composition as risk factors for necrotizing enterocolitis in very-preterm infants

Author

Jean-Christophe Rozé, Pierre-Yves Ancel, Patricia Lepage, Laetitia Martin-Marchand, Ziad Al Nabhani, Johanne Delannoy, Jean-Charles Picaud, Alexandre Lapillonne, Julio Aires, Mélanie Durox, Dominique Darmaun, Josef Neu, Marie-José Butel, Farid Boudred, Delphine Mitanchez, Charlotte Casper, Valerie Biran, Laurent Storme, Olivier Claris, Gilles Cambonie, Jacques Sizun, Anne Sauret, Odile Dicky, Emmanuel Lopez, Jean-Michel Hascoet, Geraldine Gascoin, Rachel Vieux, Blandine de Lauzon, Luc Desfrere, Clement Chollat, Marie-Jose Butel, Clotilde Rousseau, Joel Doré, Karine Le Roux, Céline Monot, Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes (UN)-Institut National de la Recherche Agronomique (INRA), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), AP-HP Hôpitaux Universitaires Paris Centre, MICrobiologie de l'ALImentation au Service de la Santé (MICALIS), Institut National de la Recherche Agronomique (INRA)-AgroParisTech, Ecosystème intestinal, probiotiques, antibiotiques (EA 4065), Department of Neonatal Medicine, University Hospital, Paris Descartes Univ, Risks Pregnancy Dept, Paris, France, Partenaires INRAE, Paris Descartes Univ, EA Intestinal Ecosyst Probiot Antibiot 4065, Fac Pharm, Paris, France, University of Florida [Gainesville] (UF), French Institute of Public Health Research/Institute of Public Health, French Health Ministry, NIH and Medical Research, National Institute of Cancer, National Solidarity Fund for Autonomy, National Research Agency [ANR-11-EQPX-0038, ANR-12-SV, ANR-12-BSV3-0025001/EPIFLORE], PremUp Foundation, and Nestec Research Center (Vers-chez-les-Blanc, Switzerland)

Subjects
Time Factors, Neonatal intensive care unit, breastfeeding, [SDV]Life Sciences [q-bio], Medicine (miscellaneous), Enteral administration, Gastroenterology, 0302 clinical medicine, Risk Factors, RNA, Ribosomal, 16S, Odds Ratio, Prospective Studies, 030212 general & internal medicine, speed of increasing enteral nutrition, 2. Zero hunger, Enterocolitis, education.field_of_study, Nutrition and Dietetics, Infant Formula, 3. Good health, Breast Feeding, Necrotizing enterocolitis, France, medicine.symptom, clostridia, Infant, Premature, Staphylococcus aureus, medicine.medical_specialty, Population, preterm infant, 03 medical and health sciences, Enteral Nutrition, Enterocolitis, Necrotizing, Intensive Care Units, Neonatal, 030225 pediatrics, Intensive care, Internal medicine, medicine, Humans, education, Clostridium, necrotizing enterocolitis, Bacteria, Milk, Human, business.industry, Infant, Newborn, Editorials, medicine.disease, digestive system diseases, Gastrointestinal Microbiome, Parenteral nutrition, Case-Control Studies, Intensive Care, Neonatal, business, Breast feeding
Abstract

International audience; Background: The pathophysiology of necrotizing enterocolitis (NEC) remains poorly understood. Objective: We assessed the relation between feeding strategies, intestinal microbiota composition, and the development of NEC. Design: We performed a prospective nationwide population-based study, EPIPAGE 2 (Etude Epidemiologique sur les Petits Ages Ges-tationnels), including preterm infants born at,32 wk of gestation in France in 2011. From individual characteristics observed during the first week of life, we calculated a propensity score for the risk of NEC (Bell's stage 2 or 3) after day 7 of life. We analyzed the relation between neonatal intensive care unit (NICU) strategies concerning the rate of progression of enteral feeding, the direct-breastfeeding policy, and the onset of NEC using general linear mixed models to account for clustering by the NICU. An ancillary propensitymatched case-control study, EPIFLORE (Etude Epidemiologique de la flore), in 20 of the 64 NICUs, analyzed the intestinal microbiota by culture and 16S ribosomal RNA gene sequencing. Results: Among the 3161 enrolled preterm infants, 106 (3.4%; 95% CI: 2.8%, 4.0%) developed NEC. Individual characteristics were significantly associated with NEC. Slower and intermediate rates of progression of enteral feeding strategies were associated with a higher risk of NEC, with an adjusted OR of 2.3 (95% CI: 1.2, 4.5; P = 0.01) and 2.0 (95% CI: 1.1, 3.5; P = 0.02), respectively. Less favorable and intermediate direct-breastfeeding policies were associated with higher NEC risk as well, with an adjusted OR of 2.5 (95% CI: 1.1, 5.8; P = 0.03) and 2.3 (95% CI: 1.1, 4.8; P = 0.02), respectively. Microbiota analysis performed in 16 cases and 78 controls showed an association between Clostridium neonatale and Staphylococcus aureus with NEC (P = 0.001 and P = 0.002). Conclusions: A slow rate of progression of enteral feeding and a less favorable direct-breastfeeding policy are associated with an increased risk of developing NEC. For a given level of risk assessed by propensity score, colonization by C. neonatale and/or S. aureus is significantly associated with NEC. This trial (EPIFLORE study) was registered at clinicaltrials.gov as NCT01127698.

Published
2017
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results