Effects Of Colostrum Oral Instillation On Very Low Birth Weight Infants Under Mechanical Ventilation

Objective The purpose of this study was to investigate the effect of oral instillation of colostrum in the very low birth weight infants under mechanical ventilation and to provide the relevant management basis for the premature infants using mechanical ventilation.Methods Using the principle of random distribution,90 cases of extremely low birth weight infants with mechanical ventilation were selected from the maternal and child health care hospital of Shandong,which were divided into the control group and the experimental group,with 45 cases in each group.The experimental group began oral colostrum infusion at 24 hours after birth and continued to drip for 7 days after birth.The control group was given oral infusion with normal saline.The preterm infants were given breast milk after enteral feeding.The evaluation index included the safety of oral infusion,the detection rate of pathogenic microbes in the pharynx and trachea of two groups of preterm infants after birth 48 and 96 hours,and the incidence of clinical infectious diseases in the two groups of preterm infants.The comparison of the feeding process of the two groups of preterm infants including the starting feeding time of the two groups of preterm infants,and the starting oral feeding time,the time of total gastrointestinal nutrition,the number of gastric retention,the incidence of feeding intolerance,the incidence of necrotizing enterocolitis and diarrhea,and the addition of the breast milk fortifier,and the observation of the indexes of the growth and development of the two groups of preterm infants,including the growth of the head circumference and the loss of weigh,the time of recovering birth weight.At the same time,we compared the common diseases and the common complications of mechanical ventilation.Results The incidence of pathogenic microbes of the experimental group in the mouth and trachea was significantly lower than the control group at 96 hours after birth(p<0.05).The incidence of ventilator associated pneumonia in the experimental group was significantly lower than that in the control group.The difference was significant(p<0.05).The time to total gastrointestinal nutrition was significantly lower than that of the control group(p<0.05),and the incidence of feeding intolerance in the experimental group was lower than that of the control group before and after the addition of the breast milk fortifier(p<0.05),and the peak value of the 7 days of high bilirubin in the experimental group was lower than that of the control group,and the increase of the head circumference in the extrauterine development was faster than that of the control group(P < 0.5);there was no significant difference in the detection rate of pathogenic microbes in the pharynx and trachea of the two preterm infants(p>0.05).The cases of septicemia and the time of antibiotics used in the two groups were not statistically significant(p>0.05),and there was no significant difference in the incidence of necrotizing enterocolitis(p>0.05);There was no statistical significance of weight gain,weight loss,time of recovery to birth weight,days of hospitalization,hypoglycemia,anemia,low calcium and other common complications of mechanical ventilation(p>0.05).Conclusion The use of oral instillation of colostrum can effectively improve the clinical symptoms of very low birth weight infants,reduce the detection rate of pathogenic microbes in the pharynx and tracheal tube 96 hours,reduce the production of ventilator-associated pneumonia,accelerate the feeding process of preterm infants,promote the growth and development of preterm infants,and be worthy of further clinical popularization.