Clinical practice guidelines for the management of enteral nutrition in the very low birth weight preterm neonate of the Peruvian Social Security (EsSalud)
DOI:
https://doi.org/10.35434/rcmhnaaa.2023.164.1941Keywords:
Enteral nutrition, Clinical Practice Guide, GRADE Approach, Evidence-Based MedicineAbstract
Introduction: This article summarizes the clinical practice guideline (CPG) for the management of enteral nutrition in premature newborns with very low birth weight in the Social Security of Peru (EsSalud). Objective: Provide evidence-based clinical recommendations for the management of premature newborns with very low birth weight in EsSalud. Methods: A guideline development group (GDG) was formed that included medical specialists and methodologists. The GDG formulated 5 clinical questions to be answered by this CPG. Systematic searches were carried out for systematic reviews and – when considered relevant – primary studies in Medline and CENTRAL during 2021. The evidence was selected to answer each of the clinical questions posed. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic working meetings, the GDG used the GRADE methodology to review the evidence and formulate recommendations, good clinical practice points, and the management flowchart. Finally, the CPG was approved with Resolution No. 071–IETSI-ESSALUD-2022. Results: This CPG addressed 5 clinical questions, all referring to the management of enteral nutrition in premature newborns with very low birth weight. Based on these questions, 5 recommendations were formulated (1 strong recommendation and 4 conditional recommendations), 5 GCP, and 1 flow chart. Conclusion: This article summarizes the methodology and evidence-based conclusions of the CPG for the management of enteral nutrition in premature newborns with very low birth weight in EsSalud.
Downloads
Metrics
References
WHO, UNICEF. Low Birthweight. Country, regional and global estimates, https://iris.who.int/bitstream/handle/10665/43184/9280638327.pdf (2004, accessed 7 January 2024).
Ticona DM, Huanco D, Ticona-Rendón MB. Impact of unplanned pregnancy on neonatal outcomes: findings of new high-risk newborns in Peru. Int Health. Epub ahead of print 21 March 2023. DOI: 10.1093/INTHEALTH/IHAD018.
Fanaroff AA, Stoll BJ, Wright LL, et al. Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol 2007; 196: 147.e1-147.e8.
WHO. Preterm and low birth weight infants. PLoS One; 16. Epub ahead of print 1 October 2021. DOI: 10.1371/JOURNAL.PONE.0258751.
Krasevec J, Blencowe H, Coffey C, et al. Study protocol for UNICEF and WHO estimates of global, regional, and national low birthweight prevalence for 2000 to 2020. Gates Open Res; 6. Epub ahead of print 2022. DOI: 10.12688/GATESOPENRES.13666.1.
Low-birthweight babies (% of births) - Peru | Data, https://data.worldbank.org/indicator/SH.STA.BRTW.ZS?locations=PE (accessed 7 January 2024).
Balshem H, Helfand M, Schünemann HJ, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol 2011; 64: 401–406.
Alonso-Coello P, Schünemann HJ, Moberg J, et al. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction. BMJ; 353. Epub ahead of print 2016. DOI: 10.1136/BMJ.I2016.
Alonso-Coello P, Oxman AD, Moberg J, et al. GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. BMJ; 353. Epub ahead of print 2016. DOI: 10.1136/BMJ.I2089.
Taylor SN, Fenton TR, Groh-Wargo S, et al. Exclusive Maternal Milk Compared With Exclusive Formula on Growth and Health Outcomes in Very-Low-Birthweight Preterm Infants: Phase II of the Pre-B Project and an Evidence Analysis Center Systematic Review. Front Pediatr; 9. Epub ahead of print 25 February 2021. DOI: 10.3389/FPED.2021.793311.
Yu F, Cao B, Wen Z, et al. Is Donated Breast Milk Better Than Formula for Feeding Very Low Birth Weight Infants? A Systematic Review and Meta-Analysis. Worldviews Evid Based Nurs 2019; 16: 485–494.
Koo W, Tank S, Martin S, et al. Human milk and neurodevelopment in children with very low birth weight: A systematic review. Nutr J 2014; 13: 1–13.
Colonetti T, de Carvalho Florêncio I, Figueiredo P, et al. Colostrum Use and the Immune System of Premature Newborns: A Systematic Review and Meta-Analysis. J Hum Lact 2022; 38: 487–500.
Ramos MDSX, Martins CDC, Souza ES, et al. Oropharyngeal colostrum immunotherapy and nutrition in preterm newborns: meta-analysis. Rev Saude Publica; 55. Epub ahead of print 2021. DOI: 10.11606/S1518-8787.2021055003051.
Ma A, Yang J, Li Y, et al. Oropharyngeal colostrum therapy reduces the incidence of ventilator-associated pneumonia in very low birth weight infants: a systematic review and meta-analysis. Pediatr Res 2021; 89: 54–62.
Tao J, Mao J, Yang J, et al. Effects of oropharyngeal administration of colostrum on the incidence of necrotizing enterocolitis, late-onset sepsis, and death in preterm infants: a meta-analysis of RCTs. European Journal of Clinical Nutrition 2020 74:8 2020; 74: 1122–1131.
Panchal H, Athalye-Jape G, Patole S. Oropharyngeal Colostrum for Preterm Infants: A Systematic Review and Meta-Analysis. Adv Nutr 2019; 10: 1152–1162.
Kumar M, Upadhyay J, Basu S. Fortification of Human Milk With Infant Formula for Very Low Birth Weight Preterm Infants: A Systematic Review. Indian Pediatr 2021; 58: 253–258.
Young L, Oddie SJ, McGuire W. Delayed introduction of progressive enteral feeds to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database Syst Rev; 2022. Epub ahead of print 20 January 2022. DOI: 10.1002/14651858.CD001970.PUB6.
Premji SS, Chessell L. Continuous nasogastric milk feeding versus intermittent bolus milk feeding for premature infants less than 1500 grams. Cochrane Database Syst Rev; 2011. Epub ahead of print 9 November 2011. DOI: 10.1002/14651858.CD001819.PUB2.
Wang Y, Zhu W, Luo B ru. Continuous feeding versus intermittent bolus feeding for premature infants with low birth weight: a meta-analysis of randomized controlled trials. Eur J Clin Nutr 2020; 74: 775.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2024 Carlos Hugo Torres Salinas, Gandy Dolores-Maldonado, Víctor Andrés Velásquez Rimachi, Yassdina Arista Montes, Anni Jessica Cary Borja, Carolina Raquel Casaverde Sarmiento, Jocelyn Milagritos Chumpitaz Huapaya, Roger Gugliano Costta Olivera, Nadia Betty Garcia Figueroa, Nancy Elizabeth Garcia Lombardi, Julissa Yamille Pita Alvarez, Martina Leonila Zegarra Linares, Alvaro Taype-Rondan, Stefany Salvador Salvador, Lourdes del Rocío Carrera Acosta
This work is licensed under a Creative Commons Attribution 4.0 International License.