EFFECT OF EARLY ENTERAL SUPPLEMENTATION OF L-ARGININE & GLUTAMINE ON PRETERM NEONATEGhada Ahmad Mohammad El Saied Saleh
Abstract.SUMMARY N ecrotizing enterocolitis (NEC) is the most common acquired gastrointestinal disease that occurs predominantly in premature infants and is considered to be one of the leading causes of morbidity and mortality in their age group (Schnabl et al., 2008). Primary prevention of NEC should be the priority, since NEC frequently progresses from nonspecific signs, to extensive necrosis within a matter of hours with medical or surgical treatment, making successful treatment and secondary prevention difficult to achieve (Lin et al., 2013). One of the assumed novel preventive measures against NEC is L-arginine & glutamine supplementation to high risk infants (Neu, 2005). We conducted a prospective, interventional, single blinded clinincal in the period from 1/2011- 3/2014 in both NICUs of Children Hospital & Maternity Hospital of Ain Shams University. The study was approved by the Ethical Committee of Faculty of Medicinie, Ain Shams University. Aim of the study was to assess the preventive role of enteral L-arginine & glutamine against NEC and to assess the role of glutamine in decreasing the impact of sepsis on premature neonates. Seventy five preterm neonates were enrolled. Inclusion criteria were GA≤ 34 weeks assigned to feed in the first week of life. Exclusion criteria were the presence of any contraindication to feeding (e.g. intestinal surgery), sever or multiple congenital anomalies, intracranial hemorrhage > grade 2 or non- bacterial congenital infection. They were equally divided into 3 groups (L-arginine group, Glutamine group & Control group), 25 neonates per group were randomly enrolled. L-arginine group included 25 preterm neonates among which 56% were females. Mean for birth weight was 1.45kg, mean for gestational age was 31.84 weeks, 72% were delivered via CS. Median for APGAR score at 1 & 5 minutes were 6 & 8 respectively. As for the glutamine group, among the 25 neonates included, 52% were females, 92% were born to CS. Mean for birth weight was 1.45kg while mean for GA was 31.84 weeks. Median for APGAR score was 5 in 1st minute (significantly lower than other 2 groups) and 8 at 5 minutes. In control group that also included 25 neonates, 56% were females and 88% were born to CS. Mean for birth weight was significantly lower if compared to other groups (1.31 kg) while GA was comparable to them (30.64). Median for APGAR score in 1 & 5 minutes was 7 & 8 respectively.
|Other Titles||دراســة تأثيــر إضــافــة الإل- أرجيـنـيــن و الجلوتـامين للتـغـذيـه الجوفـيّــه مبكــرا للمبتســـريـــن||Issue Date||2014||URI||http://research.asu.edu.eg/handle/12345678/9429|
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