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Effects of Early versus Standard Central Line Removal on the Growth of Preterm Infants with Very Low Birth Weight: A Non-Inferiority, Randomized Clinical Trial

Very preterm infants are usually supported by parenteral nutrition delivered through central lines (CLs) while progressing with enteral intake, although the optimal time point for their removal is unclear. This study evaluated the impact of the CL discontinuation time on the short-term growth outcom...

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Autores principales: Romańska, Justyna, Wawrzoniak, Tomasz, Krajewski, Paweł, Seliga-Siwecka, Joanna, Brunets, Natalia, Lehman, Izabela, Bokiniec, Renata, Adamska, Ewa, Królak-Olejnik, Barbara, Modzelewski, Jan, Szczapa, Tomasz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9692930/
https://www.ncbi.nlm.nih.gov/pubmed/36432453
http://dx.doi.org/10.3390/nu14224766
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author Romańska, Justyna
Wawrzoniak, Tomasz
Krajewski, Paweł
Seliga-Siwecka, Joanna
Brunets, Natalia
Lehman, Izabela
Bokiniec, Renata
Adamska, Ewa
Królak-Olejnik, Barbara
Modzelewski, Jan
Szczapa, Tomasz
author_facet Romańska, Justyna
Wawrzoniak, Tomasz
Krajewski, Paweł
Seliga-Siwecka, Joanna
Brunets, Natalia
Lehman, Izabela
Bokiniec, Renata
Adamska, Ewa
Królak-Olejnik, Barbara
Modzelewski, Jan
Szczapa, Tomasz
author_sort Romańska, Justyna
collection PubMed
description Very preterm infants are usually supported by parenteral nutrition delivered through central lines (CLs) while progressing with enteral intake, although the optimal time point for their removal is unclear. This study evaluated the impact of the CL discontinuation time on the short-term growth outcomes of preterm infants. A non-inferiority, parallel-group, randomized controlled trial was conducted in four neonatal intensive care units in Poland. Preterm infants with very low birth weight (VLBW) without congenital abnormalities were eligible. Patients were allocated to discontinue central access at an enteral feeding volume of 100 mL/kg/day (intervention group) or 140 mL/kg/day (control group). The study’s primary outcome was weight at 36 weeks’ postmenstrual age, with a non-inferiority margin of −210 g. Overall, 211 patients were allocated to the intervention or control groups between January 2019 and February 2021, of which 101 and 100 were eligible for intention-to-treat analysis, respectively. The mean weight was 2232 g and 2200 g at 36 weeks’ postmenstrual age in the intervention and control groups, respectively. The mean between-group difference was 32 g (95% confidence interval, −68 to 132; p = 0.531), which did not cross the specified margin of non-inferiority. No intervention-related adverse events were observed. Early CL removal was non-inferior to the standard type for short-term growth outcomes in VLBW infants.
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spelling pubmed-96929302022-11-26 Effects of Early versus Standard Central Line Removal on the Growth of Preterm Infants with Very Low Birth Weight: A Non-Inferiority, Randomized Clinical Trial Romańska, Justyna Wawrzoniak, Tomasz Krajewski, Paweł Seliga-Siwecka, Joanna Brunets, Natalia Lehman, Izabela Bokiniec, Renata Adamska, Ewa Królak-Olejnik, Barbara Modzelewski, Jan Szczapa, Tomasz Nutrients Article Very preterm infants are usually supported by parenteral nutrition delivered through central lines (CLs) while progressing with enteral intake, although the optimal time point for their removal is unclear. This study evaluated the impact of the CL discontinuation time on the short-term growth outcomes of preterm infants. A non-inferiority, parallel-group, randomized controlled trial was conducted in four neonatal intensive care units in Poland. Preterm infants with very low birth weight (VLBW) without congenital abnormalities were eligible. Patients were allocated to discontinue central access at an enteral feeding volume of 100 mL/kg/day (intervention group) or 140 mL/kg/day (control group). The study’s primary outcome was weight at 36 weeks’ postmenstrual age, with a non-inferiority margin of −210 g. Overall, 211 patients were allocated to the intervention or control groups between January 2019 and February 2021, of which 101 and 100 were eligible for intention-to-treat analysis, respectively. The mean weight was 2232 g and 2200 g at 36 weeks’ postmenstrual age in the intervention and control groups, respectively. The mean between-group difference was 32 g (95% confidence interval, −68 to 132; p = 0.531), which did not cross the specified margin of non-inferiority. No intervention-related adverse events were observed. Early CL removal was non-inferior to the standard type for short-term growth outcomes in VLBW infants. MDPI 2022-11-11 /pmc/articles/PMC9692930/ /pubmed/36432453 http://dx.doi.org/10.3390/nu14224766 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Romańska, Justyna
Wawrzoniak, Tomasz
Krajewski, Paweł
Seliga-Siwecka, Joanna
Brunets, Natalia
Lehman, Izabela
Bokiniec, Renata
Adamska, Ewa
Królak-Olejnik, Barbara
Modzelewski, Jan
Szczapa, Tomasz
Effects of Early versus Standard Central Line Removal on the Growth of Preterm Infants with Very Low Birth Weight: A Non-Inferiority, Randomized Clinical Trial
title Effects of Early versus Standard Central Line Removal on the Growth of Preterm Infants with Very Low Birth Weight: A Non-Inferiority, Randomized Clinical Trial
title_full Effects of Early versus Standard Central Line Removal on the Growth of Preterm Infants with Very Low Birth Weight: A Non-Inferiority, Randomized Clinical Trial
title_fullStr Effects of Early versus Standard Central Line Removal on the Growth of Preterm Infants with Very Low Birth Weight: A Non-Inferiority, Randomized Clinical Trial
title_full_unstemmed Effects of Early versus Standard Central Line Removal on the Growth of Preterm Infants with Very Low Birth Weight: A Non-Inferiority, Randomized Clinical Trial
title_short Effects of Early versus Standard Central Line Removal on the Growth of Preterm Infants with Very Low Birth Weight: A Non-Inferiority, Randomized Clinical Trial
title_sort effects of early versus standard central line removal on the growth of preterm infants with very low birth weight: a non-inferiority, randomized clinical trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9692930/
https://www.ncbi.nlm.nih.gov/pubmed/36432453
http://dx.doi.org/10.3390/nu14224766
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