Abstract

Introducción: La alimentación oral de los recién nacidos pretérminos (RNPT) está dificultada por su inmadurez y enfermedades intercurrentes, lo que puede prolongar su estancia hospitalaria. El objetivo de este estudio fue valorar la efectividad de un programa que combina la estimulación táctil, kinestésica y oral (ET+K+O) frente a otro de estimulación oral sola (EO), en el tiempo necesario para lograr la alimentación independiente y el alta hospitalaria. Paciente y métodos: Estudio clínico de dos grupos aleatorizados (EO frente a ET+K+O), realizado en 42 RNPT con edad gestacional (EG) entre 27-32 semanas y peso nacimiento (PN) > 900 gr. Los programas de estimulación fueron realizados en sesiones de 15 minutos, durante 10 días. Resultados: Los RNPT del grupo de ET+K+O, consiguieron antes la alimentación oral independiente, en comparación con el grupo de EO (24.9± 10.1 vs 34.1± 15.6 días, p=0.02). Se realizó un análisis de covarianza, observando que las covariables PN y EG tuvieron efectos significativos en el tiempo hasta alcanzar la alimentación por succión (PN: F (1, 38) = 5.79; p=0.021; EG: F (1, 38) =14.12; p=0.001) y que una vez controlado su efecto, la intervención seguía teniendo un efecto significativo (F (1, 38) =6.07; p=0.018). El grupo de ET+K+O, en comparación con el de EO, consiguió antes el alta hospitalaria (39±15 vs 45±18 días) si bien la diferencia no fue significativa (p=0.21). Conclusiones: Las terapias combinadas que asocian estimulación kinestésica, táctil y oral, son más eficaces que la estimulación oral sola, para lograr la alimentación oral independiente en los RNPT. Introduction: Oral feeding of pre-term newborns (PTNB) is hampered by their immaturity and intercurrent diseases, which can prolong their hospital stay. The objective of this study was to assess the effectiveness of a program that combines tactile, kinesthetic and oral stimulation (T+K+OS) compared to another intervention based on exclusively oral stimulation (OS), in the time necessary to achieve independent feeding and hospital discharge. Patients and methods: A clinical study of two randomized groups (OS versus T+K+OS) was carried out on 42 PTNB with gestational age (GA) between 27-32 weeks and birth weight (BW)> 900 gr. The stimulation programs were carried out in sessions of 15 minutes, for 10 days. Results: The PTNBs in the ET + K + O group achieved independent oral feeding earlier, compared to the EO group (24.9±10.1 vs 34.1±15.6 days, p=0.02). An analysis of covariance was performed, which confirmed that the BW and GA covariates had significant effects on time to reach suction feeding (BW: F (1, 38) = 5.79; p = 0.021; GA: F (1, 38) = 14.12; p = 0.001) and that once its effect was controlled, the intervention continued to have a significant effect ( F (1, 38) = 6.07; p=0.018). The T+K+OS group, compared to the OS group, achieved an earlier hospital discharge (39±15 vs 45±17 days), although the differences were not significant (p=0.21). Conclusions: Combined therapies that include kinesthetic, tactile, and oral stimulation are more effective than oral stimulation alone, in order to achieve independent oral feeding in PTNBs.

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