کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5718892 | 1607409 | 2017 | 7 صفحه PDF | دانلود رایگان |
ObjectiveTo evaluate the time to full enteral feedings in preterm infants after a practice change from routine evaluation of gastric residual volume before each feeding to selective evaluation of gastric residual volume , and to evaluate the impact of this change on the incidence of necrotizing enterocolitis (NEC).Study designData were collected on all gavage-fed infants born atââ¤34 weeks gestational age (GA) for 2 years before (nâ=â239) and 2 years after the change (nâ=â233).ResultsThe median GA was 32.0 (IQR: 29.7-33.0) weeks before and 32.4 (30.4-33.4) weeks after the change (Pâ=â.02). Compared with historic controls, infants with selective evaluations of gastric residual volumes weaned from parenteral nutrition 1 day earlier (Pâ<â.001) and achieved full enteral feedings (150âcc/kg/day) 1 day earlier (Pâ=â.002). The time to full oral feedings and lengths of stay were similar. The rate of NEC (stageââ¥â2) was 1.7% in the selective gastric residual volume evaluation group compared with 3.3% in the historic control group (Pâ=â.4). Multiple regression analyses showed that the strongest predictor of time to full enteral feedings was GA. Routine evaluation of gastric residual volume and increasing time on noninvasive ventilation both prolonged the attainment of full enteral feedings. Findings were consistent in the subgroup with birth weightsâof <1500 g. Increased weight at discharge was most strongly associated with advancing postmenstrual, age but avoidance of routine evaluations of gastric residual volume also was a significant factor.ConclusionsAvoiding routine evaluation of gastric residual volume before every feeding was associated with earlier attainment of full enteral feedings without increasing risk for NEC.
Journal: The Journal of Pediatrics - Volume 189, October 2017, Pages 128-134