Nutrition and metabolism of the micropremie:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2000
|
| Schriftenreihe: | Clinics in perinatology
27,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII, 254 S. graph. Darst. |
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| adam_text | NUTRITION AND METABOLISM OF THE MICROPREMIE
CONTENTS
Preface xi
Richard M. Cowett
Glucose Homeostasis in the Micropremie 1
Hussien M. Farrag and Richard M. Cowett
This article evaluates the current knowledge of the kinetics of
glucose homeostasis in the micropremie. Glucose production, glu¬
cose use, and glucose oxidation are reviewed in detail. This article
also evaluates the developmental regulation of glucose homeosta¬
sis relative to some of the fundamental differences known to exist
in the neonate compared to the adult.
Protein Metabolism of the Extremely Low Birth Weight
Infant 23
Satish C. Kahlan and Sabine Iben
Recent data on protein and nitrogen metabolism in the extremely
low birth weight neonate are presented in relation to the avail¬
able data in healthy full term and preterm infants. These data
show that the very preterm neonate has a high rate of protein
breakdown and turnover and is not responsive to nutrient and
other intervention strategies.
Lipid Metabolism of the Micropremie 57
Guy Putet
Intravenous lipid emulsions often provide substance for the very
low birth weight or extremely low birth weight infant that need
total parenteral nutrition. The process used in this type of treat¬
ment as well as the effects of such treatment are discussed at
CLINICS IN PERINATOLOGY
VOLUME 27 • NUMBER 1 • MARCH 2000 V
length in this article. Some of the main compounds of representa¬
tive lipid emulsions are listed and evaluated and the benefits and
consequences of their use are presented.
Essential Fatty Acid Metabolism in the Micropremie 71
Ricardo Uauy, Patricia Mena, and Cecilia Rojas
Lipids are structural components of all tissues and are indispens¬
able for cell membrane synthesis. The brain, retina, and other
neural tissues are particularly rich in long chain polyunsaturated
fatty acids affecting neural structural development and function.
Over recent years, the role of fatty acids in modulating signal
transduction and regulation of gene expression has been charac¬
terized. Long chain polyunsaturated fatty acids have significant
effects in the modulation of developmental processes that may
affect clinical outcomes of extremely premature infants.
Vitamin Metabolism and Requirements in the
Micropremie 95
Frank R. Greer
Vitamin metabolism and requirements are reviewed for the micro¬
premie (£ 1000 g birthweight), for parenteral and enteral feedings.
Recommendations are presented in table format. Human milk
fortifiers and special formulas for the preterm infant are reviewed.
For parenteral nutrition, only MVI Pediatric is currently available
in the United States. Two millimeters per kilogram is recom¬
mended for the micropremie as the most satisfactory method
of providing supplemental vitamins in total parenteral nutrition
solutions.
Trace Elements of the Micropremie 119
Peter J. Aggett
The current limited understanding of the ontogeny and mecha¬
nisms of the metabolism of iron, zinc, copper, selenium, iodine,
and manganese in the micropremie are reviewed. The effects of
early delivery on these processes are considered, as are the sug¬
gested amounts of these trace elements required for micropre
mies.
Water and Electrolyte Metabolism of the Micropremie 131
Stephen Baumgart and Andrew T. Costarino
There are five problem schemas presented in this article that
indicate potential contradictions in therapeutic goals: (1) shock
and edema presenting upon premature birth; (2) the hyperosmo
lar state, problematic in patients less than 750 g birth weight;
(3) the respiratory distress syndrome and respiratory failure, often
complicated by patent ductus arteriosus; (4) bronchopulmonary
vi CONTENTS
dysplasia, resulting from prematurity and mechanical ventilation;
and (5) late onset of hyponatremia, sometimes accompanied by
growth failure in the recovering premature. These five problems
considered together comprise a developmental continuum of ill¬
ness and recovery, where appropriate fluid management has re¬
cently been demonstrated to benefit outcomes greatly. Clinicians
over the past decade have encountered all of the fluid and electro¬
lyte nightmares. Although there are many different formulations
for treating each of these scenarios, recommending one approach
for all patients is likely to be incorrect much of the time.
Bone Mineral Metabolism in the Micropremie 147
Jacques Rigo, Mario De Curtis, Catherine Pieltain,
Jean Charles Picaud, Bernard Louis Salle,
and Jacques Senterre
Bone growth and mineralization result from two separate but
interrelated phenomena: matrix synthesis and mineral deposition.
During the last part of gestation, mineralization is proportionally
higher than bone growth, which results in a progressive increase
in mineral density. By contrast, after birth in ELBW infants,
growth (i.e., predominantly bone mineralization) is impaired dur¬
ing the first weeks of life leading to a progressive reduction in
bone mineral density and in the occurrence of osteopenia. Numer¬
ous factors influence growth and mineralization in the postneona
tal period, as well as the mineral status at discharge. Long
term assessment of the early linear growth deficit and skeletal
demineralization of micropremies is currently under investiga¬
tion. Despite being frequently smaller and lighter than their term
counterparts, a complete catch up of bone mineralization pre¬
dominates in these preterm infants; however, the definitive effect
on bone mass and metabolic bone disease in adults requires
further evaluation.
Bilirubin and Jaundice in the Micropremie 171
William J. Cashore
Although it has been customary to treat neonatal jaundice at
lower serum bilirubin levels in low birth weight infants than in
term infants, the threshold bilirubin levels and long term benefits
for early treatment of preterm infants have not been validated.
This article summarizes and evaluates existing evidence and strat¬
egies for early treatment of bilirubin in micropremies and recom¬
mends a conservative but flexible approach to early monitoring and
phototherapy for jaundice in extremely low birth weight infants.
Energy Expenditure in the Extremely Low Birth Weight
Infant 181
Catherine A. Leitch and Scott C. Denne
Information about energy requirements of extremely low birth
weight infants is sparse, despite the rapidly improving survival
CONTENTS vii
rates of this population. Metabolizable energy intake can be esti¬
mated from energy balance studies and the percentage of caloric
intake that is actually absorbed by these infants is approximately
87%. Data on energy expenditure in extremely premature infants
is limited; however, energy expenditure has been shown to in¬
crease with postnatal age. Because both intake and expenditure
are affected by multiple factors, there is significant variability in
estimates of the energy requirements in extremely low birth
weight infants. At present, no valid recommendations can be
made regarding optimal energy requirements for the extremely
low birth weight infant, except that their requirements probably
exceed those of stable, growing very low birth weight infants,
currently estimated at 105 to 135 kcal kg d1.
Intravenous Nutrition and Postnatal Growth of the
Micropremie 197
Patti J. Thureen and William W. Hay, Jr
This article reviews what is known and theorized about minimal,
maximal, and optimal administration of each of the major sub¬
strates in total parenteral nutrition (TPN) used in extremely low
birth weight infants. It also highlights controversial or poorly
understood issues that would benefit from further investigation.
The few studies that have been done to test for safety and efficacy
of TPN in extremely low birth weight infants are reviewed. In
this article, it is assumed that TPN should be initiated in the first
hours after birth and given in conjunction with initially small,
and then increasing, enteral feedings beginning on the first or
second day of life. TPN is considered a means to achieve rapid,
maximal nutrition and that of early enteral feeding is to prime
the gut and stimulate normal hormonal homeostasis.
Enteral Feeding of the Micropremie 221
Simon J. Newell
Clinical practice demands knowledge of gastrointestinal ontogeny
and the factors that affect our ability to use enteral feeding in the
micropremie. The decisions regarding milk type (when and how
it should be given) are considered in the light of current physio¬
logic and clinical evidence. Special considerations apply in the
micropremie who is also small for gestational age and NEC must
be avoided. Trophic feeding now has an established role, allowing
the infant to benefit from enteral feeds even when full nutritive
milk feeding is not possible.
Human Milk Feeding of the Micropremie 235
Stephanie A. Atkinson
There is increasing evidence that feeding of mother s milk to very
low birth weight and extremely low birth weight infants has
Viii CONTENTS
both immediate and long term benefits to growth and develop¬
ment of this vulnerable infant population. Although clinically
mother s milk is increasingly the feeding of choice for tiny prema¬
ture infants for the healthcare provider, this practice presents
challenges such as: careful collection and storage of the milk in
order to preserve the native milk nutrients and immune factors;
identification of the need for fortification of mother s milk with
single or multiple nutrients to ensure optimal growth and normal
biochemical status (such as plasma sodium, phosphorus, and
protein); and achievement of successful transition for gavage
feeding of expressed milk to suckling by the tiny premature
infant. Although initial growth and bone mass accretion may be
slower in infants fed mother s milk compared with those infants
fed formula, current evidence suggests that catch up growth oc¬
curs. The potential for benefits of human milk feeding in early
life for neurodevelopment and protection against infections must
be weighed against any possible detrimental effects of slower
growth in early life.
Index 249
Subscription Information Inside back cover
CONTENTS IX
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| series2 | Clinics in perinatology |
| spelling | Nutrition and metabolism of the micropremie Richard M. Cowett, guest ed. Philadelphia [u.a.] Saunders 2000 XII, 254 S. graph. Darst. txt rdacontent n rdamedia nc rdacarrier Clinics in perinatology 27,1 Métabolisme Nourrrisson très faible poids naissance Physiologie de la nutrition Prematuren gtt Prématuré Stofwisseling gtt Voeding gtt Birth weight, Low Infant Nutrition Infant, Premature metabolism Infant, Very Low Birth Weight metabolism Premature infants Metabolism Premature infants Nutrition Untergewicht (DE-588)4186979-5 gnd rswk-swf Neugeborenes (DE-588)4041781-5 gnd rswk-swf Ernährung (DE-588)4015332-0 gnd rswk-swf Stoffwechsel (DE-588)4057699-1 gnd rswk-swf Frühgeborenes (DE-588)4113644-5 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Neugeborenes (DE-588)4041781-5 s Ernährung (DE-588)4015332-0 s Stoffwechsel (DE-588)4057699-1 s DE-604 Untergewicht (DE-588)4186979-5 s Frühgeborenes (DE-588)4113644-5 s Cowett, Richard M. Sonstige (DE-588)172026849 oth Clinics in perinatology 27,1 (DE-604)BV000003382 27,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008865952&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Nutrition and metabolism of the micropremie Clinics in perinatology Métabolisme Nourrrisson très faible poids naissance Physiologie de la nutrition Prematuren gtt Prématuré Stofwisseling gtt Voeding gtt Birth weight, Low Infant Nutrition Infant, Premature metabolism Infant, Very Low Birth Weight metabolism Premature infants Metabolism Premature infants Nutrition Untergewicht (DE-588)4186979-5 gnd Neugeborenes (DE-588)4041781-5 gnd Ernährung (DE-588)4015332-0 gnd Stoffwechsel (DE-588)4057699-1 gnd Frühgeborenes (DE-588)4113644-5 gnd |
| subject_GND | (DE-588)4186979-5 (DE-588)4041781-5 (DE-588)4015332-0 (DE-588)4057699-1 (DE-588)4113644-5 (DE-588)4143413-4 |
| title | Nutrition and metabolism of the micropremie |
| title_auth | Nutrition and metabolism of the micropremie |
| title_exact_search | Nutrition and metabolism of the micropremie |
| title_full | Nutrition and metabolism of the micropremie Richard M. Cowett, guest ed. |
| title_fullStr | Nutrition and metabolism of the micropremie Richard M. Cowett, guest ed. |
| title_full_unstemmed | Nutrition and metabolism of the micropremie Richard M. Cowett, guest ed. |
| title_short | Nutrition and metabolism of the micropremie |
| title_sort | nutrition and metabolism of the micropremie |
| topic | Métabolisme Nourrrisson très faible poids naissance Physiologie de la nutrition Prematuren gtt Prématuré Stofwisseling gtt Voeding gtt Birth weight, Low Infant Nutrition Infant, Premature metabolism Infant, Very Low Birth Weight metabolism Premature infants Metabolism Premature infants Nutrition Untergewicht (DE-588)4186979-5 gnd Neugeborenes (DE-588)4041781-5 gnd Ernährung (DE-588)4015332-0 gnd Stoffwechsel (DE-588)4057699-1 gnd Frühgeborenes (DE-588)4113644-5 gnd |
| topic_facet | Métabolisme Nourrrisson très faible poids naissance Physiologie de la nutrition Prematuren Prématuré Stofwisseling Voeding Birth weight, Low Infant Nutrition Infant, Premature metabolism Infant, Very Low Birth Weight metabolism Premature infants Metabolism Premature infants Nutrition Untergewicht Neugeborenes Ernährung Stoffwechsel Frühgeborenes Aufsatzsammlung |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008865952&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| volume_link | (DE-604)BV000003382 |
| work_keys_str_mv | AT cowettrichardm nutritionandmetabolismofthemicropremie |