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Master Thesis

Intérêt de l'introduction précoce des lipides chez le grand prématuré

Abstract : Lipids are essential for the nutrition of premature neonates, as they provide energy and essential fatty acids. However their time of infusion is often delayed due to concerns regarding their tolerance. This study aims to assess the impact of early lipid infusion and their tolerance in premature neonates. Methods: We compared 132 neonates having received lipids before 24 hours of life (early lipid infusion, n=59) or during the third day (late lipid infusion, n=73). The nutritional intakes and the growth were registered during their hospital stay. Clinical and biological tolerance was studied, along with glycemic tolerance. Results: The 2 groups did not differ in gestational age, birth weight and gender. The lipid initial dose was between 0.5 and 1g/kg/d. The maximal weight loss was significantly lower in the early lipid infusion group (7.4 versus 9.3%, p=0,008), with less time required to regain birth weight in this group (8.0 versus 9.6, p=0.005), despite identical perfusion volumes. The weight at hospital discharge was greater in the early lipid infusion group (2707 vs 2521g, p=0.026). There were no criterions for poor clinical or biological tolerance. The glucose tolerance seemed better in the “early infusion group, with significantly less capillary glycaemia over 10mmo/l per patient (1.3 versus 3.6, p=0.025). The rates of complications associated with prematurity were identical in both groups. Discussion: Initial weight loss is often thought to be due to relative dehydration. Here we showed that early lipid intake reduces this initial weight loss, thus hinting that some part of malnutrition is involved. Conclusion: Early lipid infusion for the premature neonate allows a lower initial weight loss and a better growth until discharge. Furthermore it is well tolerated.
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Master Thesis
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Submitted on : Thursday, November 6, 2014 - 9:32:16 AM
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Laureline Barrielle. Intérêt de l'introduction précoce des lipides chez le grand prématuré. Médecine humaine et pathologie. 2014. ⟨dumas-01079178⟩

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