Effect of Erythromycin on Feeding Intolerance in Very Low Birth Weight Infants: A Preliminary Observation

紅黴素在極低體重早産兒的喂食：初報

蘇百弘(Bai-Horng Su) ； 林鴻志(Hong-Chih Lin) ； 彭慶添(Ching-Tien Peng) ； 蔡長海(Chang-Hai Tsai)

《Acta Paediatrica Sinica》 39卷5期 (1998/10) Pp. 324-326

https://doi.org/10.7097/APS.199810.0324

摘要

爲了解紅黴素對極低體重早産兒之腸道喂食不耐症的作用，從1997年2月到12月，有20個體重小於1500公克患有長期腸道喂食不耐症的早産兒做爲研究對象。紅黴素的方法爲：負荷劑量30mg/kg/日連續三天，每天分爲三次。每次靜脈輸注時間1小時，然後改爲維持劑量3~5mg/kg/日，每天一次靜脈輸注1小時，直到腸道喂食能完全建立爲止。紅黴素的療效是以每日胃管出入量的淨值（胃管灌食量－胃管反抽量）來評估。20個早産兒的平均懷孕週數爲27.1±2.0週，平均出生體重爲1025±196公克。開始投予紅黴素的平均日齡爲生後19.5±14日，紅黴素投予後2.4±1.1天可開始胃管喂食，15.1±2.2天後腸道喂食得以完全建立。紅黴素投予開始時的胃管出入量的淨值爲-4.8±4.1ml，投予後第七天30.6±15.3ml，第14天進爲92.6±25.4ml，第21天爲125.3±18.1ml。這個研究顯示，使用紅黴素能案例地改善極低體重早産兒的長期腸道喂食不耐症。我們建議以進一步對照研究的結果來確認紅黴素對胃腸道活動力的影響及效果。

關鍵字

紅黴素 ； 喂食不耐症 ； 極低體重早産兒

並列摘要

To investigate the effect of erythromycin on feeding intolerance in very low birth weight infants, from February 1997 to December 1997 twenty infants weighing less than 1500 g, with prolonged intolerance of enteral feeding, were enrolled in this study. The protocol for erythromycin treatment was: a loading dose of 30 mg/kg/day, divided into three portions given every eight hours intravenously for 1 hour over a three day period; then a maintenance dose of 3~5 mg/kg intravenouslyfor one hour once a day was given until full feeding was well established. The assessment of erythromycin effect was the daily net oro gastric balance (volume of oro gastric tube feeding minus volume of orogastric aspirates). The mean gestational age was 27.1±2.0 weeks (mean±SD) and the mean birth weight was 1025±196 g. The mean age when erythromycin started was 19.5±14 days; the mean days after the initiation of erythromycin when oro gastric tube feeding could be started and full feeding established were 2.4±1.1 days and 15.1±2.2 days, respectively. At the beginning of eryth.romycin treatment, the net balance of tube aspirates was -4.8±4.1 ml. The net balance rose significantly to 30.6±15.3 ml, 92.6±25.4 ml and 125.3±18.1 ml at 7, 14 and 21 days after erythromycin treatment, respectively. In conclusion, erythrotnycin treatment is a safe method to improve intolerance of enteral feeding in very low birth weight infants. It is suggested that the effect of erythromycm on gastrointestinal motility in these infants should be further investigated in the context of a randomized, controlled trial before widespread clinical implementation of this treatment.

並列關鍵字

Erythromycin ； feeding intolerance ； very low birth weight infant