Background: Routine involvement of a NNST may improve nutrition and thereby accelerate recovery from illness and reduce the duration of support required for small preterm infants. Purpose: This trial compared routine Intervention (twice weekly evaluations and recommendations by the NNST) begun at 24-96h of age to Control (selective consultation when requested by physicians) for infants ≤1250g birth weight (BW). Methods: The NNST consisted of a full-time dietitian assisted by a pharmacist and a neonatologist. The predefined primary outcome was postmenstrual age (PMA) when Intensive or Intermediate Care was no longer needed. Infants in either group who underwent bowel resection were regularly evaluated by the NNST and excluded from the primary analysis as were infants who died after enrollment. A sample size of ≥320 survivors was calculated to detect a 1 week decrease in the primary outcome. Results: 403 infants were enrolled between 9/6/93 and 11/21/97. 54 infants were excluded because of death (34) or bowel resection (20). Of the 349 remaining patients, the results (mean±SD) are available for 341 completed subjects. See Table. Conclusion: We conclude that routine evaluations of individual patients by the NNST result in a modest decrease in the duration of stay in the Intensive and Intermediate Nurseries and in time to regain BW. This trial was conducted in a large teaching hospital where the educational and programmatic efforts of the NNST apply to all NICU patients. The results obtained might only be generalizable to similar clinical settings.

Table 1 No caption available.
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