[The effects of enteral administration of glutamine enriched solution in very low birth weight infants on reducing the symptoms of feeding intolerance. A prospective, randomized pilot study]. / Wplyw enteralnej podazy roztworu wzbogaconego glutamina u noworodkow z bardzo mala urodzeniowa masa ciala, na ograniczenie objawow nietolerancji karmiena. Prospektywne, randomizowane badanie pilotazowe.

BACKGROUND: Feeding intolerance frequently occurs during the first several weeks of life in very low birth weight infants and may require the reduction of oral feeding. When significantly expressed, it may lead to the development of necrotizing enterocolitis. Apart from breast milk, also the maintenance of normal peristalsis, enterocyte nourishment and keeping a low pH value in the stomach seem to be important points in the NEC prophylaxis. AIM: The authors present the results of the randomized pilot study, performed in two, differently fed groups of VLBW newborns. The aim of the study was to compare the frequency of feeding intolerance, necrotizing enterocolitis, sepsis caused by Gram negative bacteria, intestinal perforation and the number of deaths between the study group and the control group of newborns. MATERIALS AND METHODS: 106 VLBW newborns were qualified for research. In the study group (50 newborns), apart from the mother's milk or preterm formula, infants were enteraly receiving a glutamine/ amino acid solution, the osmolality of which was comparable to amniotic fluid. The pH value of the solution was 5.5 so as to lower acidity of the stomach fluids. In the control group (56 newborns) infants were fed enteraly exclusively with the mother's milk or preterm formula. The patients in the two groups were comparable with regard to birth weight, gestational age, Apgar score and CRIB score, and the frequency of antenatal corticosteroid administration. RESULTS: There was a significantly lower risk of feeding intolerance in infants who were receiving the glutamine/amino acid solution (p=0.015). Also there was a lower risk of NEC (5 vs 10 cases), intestinal perforation (1 vs 4 cases), sepsis caused by Gram negative bacteria (1 vs 4 cases) and death (1 vs 3) in the study group. However, none of these differences reached statistical significance. CONCLUSIONS: Enteral supplementation of glutamine/amino acid solution given simultaneously with enteral feeding is safe and may significantly reduce feeding intolerance in very low birth weight infants in their first days or weeks of life. The results of our research can be useful when attempting to work out the principles of NEC prophylaxis by means of maintaining normal peristalsis, enterocyte nourishment and keeping a low pH value in the stomach.