RESUMO
A decrease in food intake during the acute phase of lower respiratory tract infections may affect the course of illness. To determine if enteral feeding improves the clinical course of lower respiratory infections (LRI) we studied 42 infants (2 to 12 months of age) with LRI which were given antibiotics and salbutamol therapy based on clinical and X-ray findings. On admission to the hospital patients were randomly allocated to group A (fed by nasogastric tube as intermittent bolus); group B (infants fed by continuous drip via nasogastric tube) and group C (subjects fed ad-libitum by the oral route). Feedings consisted of powdered whole cow's milk formula, reconstituted to 7.5% (W/V), with added sucrose 5% and maltodextrin 5% (77 kcal/dl). Energy intake in group A increased from 69 to 110 kcal.kg.day; in group B, from 68 to 114 kcal.kg.day, and in group C, from 55 to 109 kcal.kg.day (ANOVA, p < 0.005 for the first three days). Infants of groups A and B had shorter hospital stays than C (8.7 and 8.4 vs. 9.8 days, ANOVA, p < 0.02) and a faster improvement of respiratory failure index (4.1 and 3.8 vs. 5.5. days, p < 0.001). Groups A and B also showed greater decrease in their heart rates (mean 170 down to 134 beats/min) than group C patients (169 down to 142 beats/min), p < 0.01 at discharge from the hospital. No differences were noted in trends of respiratory rate, weight/length, albuminemia, C-reactive protein, erythro-sedimentation rate or glycemia. No adverse effects of nasogastric tube feeding were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Broncopneumonia/complicações , Nutrição Enteral , Transtornos da Nutrição do Lactente/terapia , Infecções Respiratórias/complicações , Albuterol/uso terapêutico , Antibacterianos/uso terapêutico , Broncopneumonia/diagnóstico , Broncopneumonia/tratamento farmacológico , Estudos de Coortes , Feminino , Humanos , Lactente , Transtornos da Nutrição do Lactente/etiologia , Recém-Nascido , Masculino , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/tratamento farmacológicoRESUMO
Three cases of glycogenosis are presented. They were recognized by clinical evidence and hepatic biopsy specimens. Dietary treatment with a normocaloric diet and raw corn starch every 6 hours was given. In cases 1 and 2 hepatic size returned to normal and they showed an initial catch up growth without signs of renal disease or other complications. Case 3 showed persistent hepatomegaly, normal growth pattern and no hypoglycemic episodes independently of nutritional management. These cases represent our initial experience on nutritional intervention in glycogenosis, even though enzymatic tests were not done, which are considered essential for optimal diagnosis and nutritional therapy of glycogen storage disease.