Cerrahi yenidoğanları nasıl besliyoruz
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Abstract:
Objective: In this study we aimed to investigate the type of enteral feeding in newborns that have been operated for various reasons. Materials and methods: We investigated retrospectively the cases which were diagnosed, treated and followed up in our surgical intensive care unit between 2001 and 2002. All cases were studied according to their age at presentation, weight, initiation and mode of oral feeding. Six groups were setup for the investigation: patients with laparatomy and resection anastomosis (group 1), patients with laparatomy without intestinal resection anastomosis (group 2), patients with stoma (group 3), patients operated for esophageal atresia (group 4), patients with toracotomy (group 5) and the others (sacrococcygeal teratoma, urinary system pathologies etc, group 6). Results: 44 cases were included in our study. Female/male ratio was 1/3 and the mean age at presentation was 3, 4 days (1-33). The mean weight was 2695 gm (12863960). Group1 (n=11): The mean duration between operation and initiation of enteral feeding was 4, 8 days (1-6). While 9 cases were being fed orally 2 cases were started nasogastric feeding. Feeding was in the mode of 3+1 (3 hours continuously + 1 hour interval and checking residue). Feeding was increased gradually according to the amount of residue. Group 2 (n=8): The mean duration between operation and initiation of enteral feeding in these cases was 3, 5 days (1-14) and the mean amount was 9,5cc (2-30). All the cases were started to be fed orally and increased gradually. Group 3 (n=10): The mean duration between operation and initiation of enteral feeding in these cases was 1,5 days (1-3) and the mean amount was 5cc. Group 4 (n=8): In esophagial atresia cases duration of time of starting feeding was 4,3 days (3-6). 5 cases were started orally and 3 cases with nasogastric mode with the amount of 3,3cc (3-5). Group 5 (n=2): Cases with toracotomy were fed posoperatively on day 1 with 5cc. Group 6 (n=6): All other cases were fed postoperatively on day 1 with 15cc (5-30). Conclusion: In this study, the cases in which intestinal resection was performed were found to be fed latest and oral feeding was the type of feeding preference. Except for the clinically high risk cases (short bowel syndrome, sepsis and ventilator therapy) postoperative early enteral feeding can be tolerated easily in the newborn patients and with this feeding strategy the complications of parenteral feeding can be avoided.Keywords:
Enteral administration
Stoma (medicine)