Avaliação das práticas de terapia nutricional enteral em recém-nascidos prematuros da unidade neonatal de uma maternidade pública

Abstract

The present study aimed to evaluate the practices of enteral nutrition therapy (ENT) in premature newborns hospitalized in the neonatal intensive care unit (NICU). This is a prospective, longitudinal, observacional study conducted on all premature newborns hospitalized in Maternidade-Escola da UFRJ, in the period April to August 2012 that met the criteria for inclusion and exclusion, which resulted in a series of 34 newborns. Statistical analyzes were calculated measures of central tendency and dispersion for continuous variables. It was used Pearson correlation to assess the degree of correlation between two continuous variables, considered as statistical significance level p value <0.05. Regarding nutritional support, the average initiation of ENT was 22.4 (SD + 29.8) hours and the average time to establish ENT full was 9.5 (SD ± 3.2) days. Newborns with low weight and gestational age had the longest start of TNE (r = - 0.58, r = - 0.55, p <0.001). It was observed that the lower the Apgar 1 minute, the greater the time to start enteral trophic nutrition (ETN) (r = - 0.55, p <0.001). A positive correlation (r = 0.41, p <0.026) between the start of ENT and length of stay in the NICU. The diets used for early ETN was infant formula specific for preterm (94.1%), followed by infant formula combined with human milk (5.9%). There was a trend towards a positive correlation, although weak (r = 0.35, p <0.066) between the onset of breast milk and the length of stay in the NICU, showing a trend in discharge from the intensive care unit faster when you started the breast milk earlier. This study has contributed to greater knowledge about the nutritional practices for preterm infants and, although advances in relation to the onset of NET have been observed, a progression that nutrition is still slow (<20ml/kg/dia). Note that there is still a wide variation in the nutritional approach to premature newborns. Therefore, building nutritional protocols and the establishment of multidisciplinary team of nutritional therapy have been suggested in the literature as a strategy to improve neonatal outcomes and future impacts.