132 Probiotic supplementation and feeding tolerance in preterm infantsg
Notice bibliographique
Résumé
Probiotic bacteria are defined as live nonpathogenic bacteria species that normally reside in the GI tract of healthy infants. In VLBW preterm infants probiotics have played a defined role in the prevention of NEC. The use of probiotics has now increased across Canada including neonates and infants who are not at high risk for NEC, and is thought to improve ‘feeding tolerance’. Probiotics are now also increasingly being given to former NICU patients by parents. The role of probiotics in more mature preterm infants has been poorly studied however and its use in these infants extends to beyond the NICU period. To determine whether the administration of probiotics: Florababy (FB), Biogaia (BG) compared with no supplementation is beneficial to the preterm infant born between 30–33+ weeks gestation. Institutional Research Ethics Board (REB) approval was obtained. A comparative prospective chart review of neonatal patients from 30–33 weeks completed gestation (GA) were analyzed from the Neonatal Intensive Care unit at St. Michael’s hospital prospectively, from 2015–2018. A convenience sample of neonates (inborn and retro-transferred) who were treated as per routine clinical orders (FB, BG or no treatment) were then included for analysis. Exclusion criteria included congenital gastrointestinal/surgical abnormalities, families unable to communicate in English and infants that were apprehended by children’s services. The primary outcome was feeding tolerance, estimated through the following variables: time to full feeds, number of aspirates/emesis, spells with feeds and other symptoms of gastroesophageal reflux disease. Secondary outcomes included: incidence of Necrotizing enterocolitis (NEC), bloody stools and length of stay. A total of 110 infants were analyzed (60% male). 40 infants received FB, 30 received BG treatment and 40 infants received no probiotic treatment during their neonatal stay. The mean gestational age of the cohort was 31.4 weeks (+/- standard deviation (SD) 1.9 weeks). Mean birth weight was 1659 grams (+/- 223 grams). Breast milk was used exclusively 67.2% of all infants, including donor milk. 18 of the 110 (16.3%) infants demonstrated symptoms of feeding intolerance however there was no statistical difference amongst the three groups (FB n=7, BG n=3, control =8). There was no difference noted in the days to full feeds (mean 8.8 +/ 2.2 days). 11 out of the 110 (10%) infants presented with blood in their stool at some point during their hospitalization, with no differences between groups (n=2 BG, FB n=5, BG n=2, control n=4). No NEC was observed. Groups were not statistically different with respect to LOS (mean 36.6 +/10.7 days). Those infants with feeding intolerance did have a lower gestational age, lower birth weight, longer length of stay and lower gestational age did correspond with more days on TPN and longer times to reach full feeds. Symptoms of feeding intolerance were not higher in thoses who received formula (Kruskal-Wallis test p =0.5708). Our study was limited by design and numbers of charts analyzed. In our comparative cohort study of preterm infants with a gestational age of 30–33 weeks, we found no advantage to routine use of probiotics. Although our study is limited by design and patient numbers we feel that the use of probiotics (and/or discontinuation of probiotics) needs to be thoughtful since there are cost implications to these medications, and parents often give them to their babies following NICU discharge.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».