Providing very low-birth-weight infants with fast enteral feeding reduced how long they needed a central venous catheter.

Abstract

To determine the impact of the protocol change from slow to fast enteral feeding progression on duration of central venous catheter placement, and the rates of late-onset sepsis and necrotising enterocolitis. We compared the evolution of all very low-birth-weight infants admitted on their first postnatal day in neonatal intensive care unit during a 12-month period, before (2021 Cohort) and after (2022 Cohort) implementation of a new feeding protocol. Linear regression model was used to adjust for confounding factors. A total of 343 VLBW infants were included (median gestational age ± SD 28.3 ± 1.7 weeks; median birth weight ± SD 980 ± 300 g). Median initial duration of central venous catheter was 5 days in 2022 cohort compared with 9 days in 2021 cohort (unadjusted p = 0.006, adjusted p = 0.001). Median time to achieve full enteral feeding was 8 days versus 12 days, p < 0.001, with no significant difference in late-onset sepsis or necrotising enterocolitis rates. The change from slow to fast enteral feeding progression for very low-birth-weight infants significantly decreased the central venous catheter duration with no adverse outcomes. This is consistent with recent randomised study results and supports the safe implementation in neonatal intensive care units.