Dieta enteral mínima durante hipotermia terapêutica neonatal: uma estratégia protetora

Abstract

Neonatal therapeutic hypothermia is the treatment for moderate or severe ischemic hypoxic encephalopathy, however, there are controversies in clinical practice related to nutritional management, the present study evaluates a nutritional therapy protocol used during the Therapeutic Hypothermia procedure in newborns with moderate or severe hypoxic-ischemic encephalopathy in the Neonatal Unit of the Pedro Ernesto University Hospital. Intervention study in a prospective cohort. The unit's nutritional protocol provides for the start of an enteral nutrition during Therapeutic Hypothermia when the newborn is hemodynamically stable. The date on which the nutrition began, the type of milk received, the time when the newborn reached a full oral diet, the time of venous access and the presence of necrotizing enterocolitis were recorded. Of the 71 newborns submitted to Therapeutic Hypothermia, 59 newborns were included, after exclusion due to death or transfer to the other hospital. Of these, 47 received a minimal enteral nutrition with human milk (from the Human Milk Bank) and 12 did not receive nutrition; no newborn received formula. During the analyzed period, no cases of necrotizing enterocolitis were observed. The mean number of days to reach a full nutrition was lower in those who received minimal enteral nutrition (with nutrition: 7.2 days; without nutrition: 13 days – p-value = 0.0001). The average number of days of use of venous catheters was lower in newborns who received nutrition (with nutrition: 8.2 days; without nutrition 14 days: – p-value=0.0001). The results showed that the nutrition with human milk with a stable newborn was safe during Therapeutic Hypothermia, denote in less time with venous catheters and less time to reach a full nutrition, without the development of necrotizing enterocolitis. However, further studies are needed to confirm these findings