Abstract
Nutritional support of extremely low-birth-weight infants has a critical role in the prevention, amelioration and recovery from bronchopulmonary dysplasia (BPD). Despite studies demonstrating the importance of providing adequate energy, protein and certain nutrients, no evidence-based nutritional guidelines exist. Attempts to improve outcomes with nutritional supplementation have been unsuccessful. These have included nutrients to enhance protection from oxidative lung injury (vitamin E, selenium, N-acetyl cysteine, superoxide dismutase), to improve surfactant function (inositol) and to improve pulmonary cell growth and differentiation (vitamin A). Only vitamin A has shown modest benefit. After infants with BPD move to the convalescent phase of their neonatal intensive care unit (NICU) stay, they continue to require extra energy and protein to grow at appropriate rates. Enriched formulas have shown promise, but standard supplementation schemes with commercial human milk fortifiers may be inadequate to meet the infant's needs. Efforts to individualize the amount of fortification guided by twice-weekly blood urea nitrogen determinations have led to improved gains in weight, length and head circumference.
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Acknowledgements
This is a summary of the presentation delivered at the third Annual Evidence versus Experience in Neonatal Practices Meeting held in June 2006, Boston, MA, USA.
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Young, T. Nutritional support and bronchopulmonary dysplasia. J Perinatol 27 (Suppl 1), S75–S78 (2007). https://doi.org/10.1038/sj.jp.7211725
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DOI: https://doi.org/10.1038/sj.jp.7211725
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