Żywienie parenteralne noworodków donoszonych i urodzonych przedwcześnie na oddziale intensywnej terapii

Parenteral nutrition of term and preterm neonates in the neonatal intensive care unit

Iwona Maroszyńska

Klinika Intensywnej Terapii i Wad Wrodzonych Noworodków i Niemowląt Instytutu Centrum Zdrowia Matki Polki w Łodzi

Iwona Maroszyńska
Klinika Intensywnej Terapii i Wad
Wrodzonych Noworodków i Niemowląt
Instytut Centrum Zdrowia Matki Polki w Łodzi
ul. Rzgowska 281/289, 93-338 Łódź
Tel.: 42 271 14 18

Wpłynęło: 11.03.2019
Zaakceptowano: 08.04.2019
Opublikowano on-line: 15.04.2019

Cytowanie / Citation

Maroszyńska I. Żywienie parenteralne noworodków donoszonych i urodzonych przedwcześnie na oddziale intensywnej terapii.
Postępy Neonatologii 2019;25(1):1–11
doi: 10.31350/postepyneonatologii/2019/1/PN2019009

Wersja elektroniczna / Article ePDF

Streszczenie:
Rozwój noworodka z ekstremalnie małą masą ciała (ELBW) w chwili porodu nie jest zakończony. Ostatni trymestr ciąży to okres bardzo intensywnego rozwoju mózgu i wrodzonej odpowiedzi obronnej. Ten rozwój jest kontynuowany w środowisku intensywnej terapii, dziecko wówczas jest narażone na katabolizm i musi być żywione parenteralnie, ponieważ nie jest w stanie zaspokoić większości swoich potrzeb żywieniowych drogą przewodu pokarmowego. Celem żywienia noworodków jest dostarczenie składników odżywczych koniecznych do odpowiedniego wzrostu i rozwoju dziecka. Niedobór niezbędnych składników odżywczych, to jest glukozy, aminokwasów, lipidów, elektrolitów, witamin, pierwiastków śladowych, prowadzi do zaburzeń wzrastania, wiąże się z większą chorobowością oraz gorszym rozwojem fizycznym i psychoruchowym. Odpowiednio wcześnie rozpoczęte żywienie – zarówno enteralne, jak i parenteralne – pokarmem o prawidłowej zawartości białka i kalorii poprawia odległe rokowanie oraz może mieć wpływ na zmniejszenie ryzyka chorób przewlekłych w dorosłym życiu.

Słowa kluczowe: noworodek, żywienie parenteralne, glukoza, tłuszcze, aminokwasy

Abstract:
Extremely low birth weight infants (ELBW) are born at a time when the fetus undergoes rapid intrauterine brain and innate immunity development and body growth. Continuation of this growth in the first several weeks postnatally i.e. when these infants are on ventilator support and receive critical care is often a challenge. These newborns are usually highly stressed and at risk for catabolism. Parenteral nutrition is needed because most of them cannot meet the nutritional needs with the enteral route. The goal of nutrition of a newborn is to provide nutrients for appropriate growth and development. Failure to provide necessary amount of all essential nutrients: glucose, amino acids, lipids, electrolytes, vitamins, trace elements leads not only to growth failure but also to increased morbidity and less-than-optimal neurodevelopment. Enhanced nutrition of very preterm infants, both intravenous and enteral, beginning right after birth, promotes positive energy and protein balance and improves long-term neurodevelopmental outcomes. The benefits are long-lasting too, particularly for prevention of chronic diseases in the future.

Key words: preterm, parenteral nutrition, glucose, lipids, amino acids

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Konflikt interesów: nie zgłoszono.
Potential conflicts of interest: no conflicts.

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