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Judith Behnke, Vanessa Estreich, Frank Oehmke, Klaus-Peter Zimmer, Anita Windhorst, Harald Ehrhardt. Compatibility of rapid enteral feeding advances and non-invasive ventilation in preterm infants – an observational study. doi: 10.1002/ppul.25868.

Aim: To evaluate safety and clinical outcome of rapid enteral feeding advances in preterm infants
<1500g birthweight (BW).

Methods: In this single-centre retrospective cohort study 293 preterm infants born during 2015-2018 were comparatively analyzed before (n=145) and after (n=148) the implementation of a rapid enteral feeding protocol with daily milk increments of 20-30 mL per kilogram of body weight. Major outcome  parameters were focused towards pulmonary morbidities and nutritional variables.

Results: Preterm infants in the rapid feeding advancement group were more successfully stabilized on  non-invasive ventilation (p < 0.001) never requiring mechanical ventilation. Duration of respiratory support (0.465) and frequency of bronchopulmonary dysplasia (BPD) (p=0.341) and severe BPD (0.273)  did not differ between both groups. Furthermore, patients in the rapid feeding group achieved full
volume feedings faster (p < 0.001), regained BW earlier (p = 0.009) and displayed significantly improved somatic growth at 36 weeks gestational age(p < 0.001). There was no increased risk for further morbidities of prematurity including feeding intolerance, necrotising enterocolitis (NEC) and focal intestinal perforation.

Conclusion: Rapid enteral feeding advancements in preterm infants <1500g BW are safe anddo not impede stabilization on non-invasive ventilation.


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