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Monatsschrift Kinderheilkunde

, Volume 167, Issue 1, pp 7–10 | Cite as

Darmentleerung sehr unreifer Frühgeborener

Aktuelle Evidenz und eigenes Vorgehen
  • Orsolya Genzel-BoroviczenyEmail author
Leitthema
  • 221 Downloads

Zusammenfassung

Bei sehr kleinen Frühgeborenen kann es bis zur ersten spontanen Mekoniumpassage Tage dauern, was oft den enteralen Nahrungsaufbau verlangsamt, besonders bei nichtinvasiv beatmeten Frühgeborenen mit einem geblähten Abdomen. Inwieweit der enterale Nahrungsaufbau durch Einläufe oder Zäpfchen gefördert werden kann, ist durch Studien nicht eindeutig belegt. Für keine der verschiedenen Methoden der Unterstützung der Darmentleerung ist ein Vorteil nachgewiesen. Ebenso ist das Risiko einer Darmperforation insbesondere bei wiederholtem Anspülen unbekannt. Maßnahmen zur Beschleunigung der Darmpassage sind weit verbreitet, aber nicht evidenzbelegt. Das Risiko einer isolierten Darmperforation sollte bei der Entscheidung zu Therapiemaßnahmen berücksichtigt werden.

Schlüsselwörter

Mekoniumpassage Rektaler Einlauf Suppositorien Fokale intestinale Perforation Enteraler Nahrungsaufbau 

Meconium passage in very immature preterm infants

Current evidence and own approach

Abstract

Spontaneous passage of meconium in very low birthweight (VLBW) infants can last for days, which often slows advancement of enteral feeding, particularly in non-invasively ventilated infants with an extended abdomen. To what extent the advancement of enteral feeding can be promoted by enemas or suppositories has not been clearly elucidated by studies. None of the different methods of fostering stool passage has been shown to significantly reduce the time to full enteral feeding. The risks of repeated enemas, such as intestinal perforation by repeated flushing have also not been sufficiently evaluated. The use of suppositories and enemas in very preterm infants is widespread but not confirmed by evidence. The risk of isolated bowel perforation should be taken into account when considering such procedures.

Keywords

Meconium passage Suppository Enema Focal intestinal perforation Enteral feeding 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

O. Genzel-Boroviczeny gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Neonatologie, Dr. von Hauner KinderspitalKlinikum der Universität München Campus InnenstadtMünchenDeutschland

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