Med Bull Sisli Etfal Hosp. 2025; 59(1): 113-118 | DOI: 10.14744/SEMB.2025.34356

Enteral Nutrition in Newborns with Hypoxic - Ischemic Encephalopathy Undergoing Therapeutic Hypothermia

Mehmet Fatih Deveci¹, Zehra Arslan², Ayse Unal Yuksekgonul³, Osman Kosek^4
1Division of Neonatology, Department of Pediatrics, Harran University Faculty of Medicine, Sanliurfa, Türkiye
²Department of Neonatology, Ankara Etlik City Hospital, Ankara, Türkiye
³Department of Pediatric Cardiology, Ankara Bilkent City Hospital, Ankara, Türkiye
⁴Public Health Department, Sanliurfa, Türkiye

Objectives: Clinicians are uncertain about the nutrition of patients diagnosed with hypoxic-ischemic encephalopathy due to the risk of necrotizing enterocolitis and feeding intolerance. The nutritional protocols of these patients are still unclear. We aimed to investigate the time of starting nutrition and related conditions in these patients receiving therapeutic hypothermia (TH) treatment.
Methods: This retrospective single-center study evaluated patients hospitalized at our unit and receiving TH between January 2022 and June 2023. Those who started nutrition during TH and after TH were defined as the early enteral nutrition (EEN) and late enteral nutrition (LEN) groups, respectively. Analyses were performed between the two groups.
Results: Our study evaluated 91 patients, of whom 40 were in the EEN group and 51 were in the LEN group. The reaching birth weight time in the LEN group was delayed (10 [5-22] vs. 7.5 [5-25] days, respectively, p<0.001), the transition time to full enteral nutrition was longer (10 [6-20] vs. 7 [5-18] days, respectively, p<0.001), and the hospitalization time was longer (13 [8-43] vs. 9 [7-35] days, respectively, p<0.001) compared with those of the EEN group.
Conclusion: TH is not an obstacle to starting nutrition. Starting nutrition in these patients at an early stage does not increase nutritional complications and shortens their discharge time.

Keywords: Feeding intolerance, hypoxic ischemic encephalopathy, necrotizing enterocolit, nutrition

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Terapotik Hipotermi Uygulanan Hipoksik Ýskemik Ensefalopatili Yenidoðanlarda Beslenme

Mehmet Fatih Deveci¹, Zehra Arslan², Ayse Unal Yuksekgonul³, Osman Kosek^4
1Harran Üniversitesi Týp Fakültesi, Çocuk Saðlýðý ve Hastalýklarý Anabilim Dalý, Neonatoloji Bilim Dalý, Þanlýurfa
²Ankara Etlik Þehir Hastanesi, Neonatoloji Kliniði, Ankara
³Ankara Bilkent Þehir Hastanesi, Pediatrik Kardiyoloji Kliniði, Ankara
⁴Halk Saðlýðý Müdürlüðü, Þanlýurfa

Amaç: Klinisyenler hipoksik-iskemik ensefalopati tanýsý almýþ hastalarýn beslenmesi konusunda nekrotizan enterokolit ve beslenme intoleransý riski nedeniyle þüphecidirler. Bu hastalarýn beslenme protokolleri hala belirsizdir. Biz, terapötik hipotermi (TH) tedavisi alan bu hastalarda beslenmeye baþlama zamanýný ve ilgili durumlarý araþtýrmayý amaçladýk.
Metot: Bu retrospektif tek merkezli çalýþmada, Ocak 2022 ile Haziran 2023 arasýnda ünitemizde yatan ve TH alan hastalar deðerlendirildi. TH sýrasýnda ve TH'den sonra beslenmeye baþlayanlar sýrasýyla erken enteral beslenme (EEB) ve geç enteral beslenme (GEB) gruplarý olarak tanýmlandý. Ýki grup arasýnda analizler yapýldý.
Bulgular: Çalýþmamýzda 40'ý EEB grubunda ve 51'i GEB grubunda olmak üzere toplam 91 hasta deðerlendirildi. GEB grubunda doðum aðýrlýðýna ulaþma süresi (10 [5-22] - 7,5 [5-25] gün, p<0,001), tam enteral beslenmeye geçiþ süresi (10 [6-20] - 7 [5-18] gün, p<0,001), hastanede kalýþ süresi (13 [8-43] - 9 [7-35] gün, p<0,001) EEB grubuna göre daha uzundu.
Sonuç: TH beslenmeye baþlamanýn önünde bir engel deðildir. Bu hastalarda beslenmeye erken dönemde baþlanmasý beslenme komplikasyonlarýný artýrmaz ve taburcu olma sürelerini kýsaltýr. (SETB-2025-01-014)

Anahtar Kelimeler: Beslenme intoleransý, hipoksik iskemik ensefalopati, nekrotizan enterokolit, beslenme

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