Impact de la Mise en Place d’un Protocole d’Oralité dans un Service de Néonatologie

RESUME Introduction . La prematurite entraine une immaturite neurologique et physiologique, qui requiert assez souvent des soins envahissants pour la survie du nouveau-ne. Ces soins peuvent entraver la mise en place de l’oralite et favoriser la prolongation du sejour hospitalier. Objectif. Evaluer l’impact du protocole oralite sur l’autonomie alimentaire dans un service de neonatologie. Materiel et methodes. Etude retrospective descriptive et analytique sur les prematures de 32 et 32 SA+6 jours, non ventiles mecaniquement et sans pathologie malformative au service de neonatologie du Centre Hospitalier Sud Francilien (CHSF) de Juin 2014 a Novembre 2016. Resultats. 23 enfants ont inclus, de poids de naissance median (PNM) = 1770 g avec des extremes de [1030-1210 g]. Quatre etaient hypotrophes. L’acquisition de l’oralite a ete plus tardive chez les hypotrophes, (p = 0,09). L’autonomisation alimentaire a ete plus precoce chez ceux qui n’avaient pas ete ventiles plus de 48 h (p=0,016) et chez ceux qui n’avaient pas ete sous nutrition parenterale prolongee (p = 0,05). La corticotherapie antenatale semble avoir peu influence positivement l’oralite (p = 0,81). Le protocole oralite a permis un gain de 15 jours dans l’autonomie alimentaire (38 SA +4 versus 36 SA+1). Conclusion. Le Protocole oralite a permis une nette progression de l’âge de l’autonomie alimentaire dans le service de neonatalogie. ABSTRACT Background. Prematurity is associated with neurological and physiological immaturity, which often requires invasive care for the newborn's survival. This care may hinder the implementation of the orality and promote the extension of the hospital stay. Objective. To evaluate the impact of the oral protocol on food self-sufficiency in a neonatology service. Methods. This was a cross sectional descriptive and analytical retrospective study on the premature infants of 32 and 32 AS + 6 days, not mechanically ventilated and without malformation pathology in the service of neonatology of the South Francilian Hospital Center (CHSF) from June 2014 to November 2016. The data were collected in the hospitalization files. Results. Twenty three babies (23) were included. The median birth weight (MPN) was 1770 (extremes of 1030 and 1210 g]. Four or them were hypotrophic. The acquisition of orality was delayed in the hypotrophic babies(p = 0.09). Food independence was present earlier in those who were ventilated for less than 48 hours (p = 0.016) and in those who had not been on prolonged parenteral nutrition (p = 0.05). Antenatal corticosteroid therapy appears to have positively influenced oral behavior (p = 0.81). The oral protocol allowed a gain of 15 days in the food autonomy (38 SA +4 versus 36 SA + 1. Conclusion. The oral protocol allowed a significant increase in the age of food autonomy in the neonatology department.