1.
Glycerin laxatives for prevention or treatment of feeding intolerance in very low birth weight infants.
Anabrees, J, Shah, VS, AlOsaimi, A, AlFaleh, K
The Cochrane database of systematic reviews. 2015;(9):CD010464
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Abstract
BACKGROUND Feeding intolerance is a common clinical problem among preterm infants. It may be an early sign of necrotising enterocolitis, sepsis or other serious gastrointestinal conditions, or it may result from gut immaturity with delayed passage of meconium. Glycerin laxatives stimulate passage of meconium by acting as an osmotic dehydrating agent and increasing osmotic pressure in the gut; they stimulate rectal contraction, potentially reducing the incidence of feeding intolerance. OBJECTIVES To assess the effectiveness and safety of glycerin laxatives (enemas/suppositories) for prevention or treatment of feeding intolerance in very low birth weight (VLBW) infants. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 4), MEDLINE, EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). We restricted our search to all randomised controlled trials and applied no language restrictions. We searched the references of identified studies and reviews on this topic and handsearched for additional articles. We searched the database maintained by the US National Institutes of Health (www.clinicaltrials.gov) and European trial registries to identify ongoing trials. SELECTION CRITERIA We considered only randomised or quasi-randomised controlled trials that enrolled preterm infants < 32 weeks' gestational age (GA) and/or < 1500 g birth weight. We included trials if they administered glycerin laxatives and measured at least one prespecified clinical outcome. DATA COLLECTION AND ANALYSIS We used standard methods of The Cochrane Collaboration and its Neonatal Group to assess methodological quality of trials, to collect data and to perform analyses. MAIN RESULTS We identified three trials that evaluated use of prophylactic glycerin laxatives in preterm infants. We identified no trials that evaluated therapeutic use of glycerin laxatives for feeding intolerance. Our review showed that prophylactic administration of glycerin laxatives did not reduce the time required to achieve full enteral feeds and did not influence secondary outcomes, including duration of hospital stay, mortality and weight at discharge. Prophylactic administration of glycerin laxatives resulted in failure of fewer infants to pass stool over the first 48 hours. Included trials reported no adverse events. AUTHORS' CONCLUSIONS Our review of available evidence for glycerin laxatives does not support the routine use of prophylactic glycerin laxatives in clinical practice. Additional studies are needed to confirm or refute the effectiveness and safety of glycerin laxatives for prevention or treatment of feeding intolerance in VLBW infants.
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A meta-analysis of the effects of glycerol-induced hyperhydration on fluid retention and endurance performance.
Goulet, ED, Aubertin-Leheudre, M, Plante, GE, Dionne, IJ
International journal of sport nutrition and exercise metabolism. 2007;(4):391-410
Abstract
The authors determined, through a meta-analytic approach, whether glycerol-induced hyperhydration (GIH) enhances fluid retention and increases endurance performance (EP) significantly more than water-induced hyperhydration (WIH). Collectively, studies administered 23.9 +/- 2.7 mL of fluid/kg body weight (BW) with 1.1 +/- 0.2 g glycerol/kg BW, and hyperhydration was measured 136 +/- 15 min after its onset. Compared with WIH, GIH increased fluid retention by 7.7 +/- 2.8 mL/kg BW (P < 0.01; pooled effect size [PES]: 1.64 +/- 0.80, P < 0.01, N = 14). The use of GIH was associated with an improvement in EP of 2.62% +/- 1.60% (P = 0.047; PES: 0.35 +/- 0.13, P = 0.014, N = 4). Unarguably, GIH significantly enhances fluid retention better than WIH. Because of the dearth of data, the effect of GIH on EP must be further investigated before more definitive conclusions can be drawn as to its ergogenic property.