Work

Use of transpyloric feeds in extremely low birth weight infants at risk of severe bronchopulmonary dysplasia—a single center experience

Year: 2024

Type: article

Abstract: Introduction: The incidence of severe BPD (sBPD), defined as needing oxygen or positive pressure at 36 weeks corrected gestational age (CGA), has remained unchanged. These infants are at risk for developing late pulmonary hypertension (LPHN) or needing surgical interventions such as Gastrostomy Tubes (GT) or Tracheostomy Tubes (TT). The finding of pepsin in the lungs of infants who were extremely low birth weight (ELBW) with sBPD has led to the speculation that gastroesophageal reflux (GER) and aspiration could contribute to their lung disease. Micro-aspiration-reducing strategies such as Transpyloric feeds (TpF) have not been well studied. Objectives: To compare ELBW infants with sBPD managed with or without TpF and determine the difference between the two groups for (i) illness severity, (ii) LPHN, (iii) need for GT, and (iv) TT; the secondary aim was to study the TpF group to (i) evaluate the change in Respiratory Severity Score (RSS) before and after TpF, and (ii) evaluate the time taken to affect the change in RSS. Methods: In this retrospective study there were 229 ELBW infants with sBPD (78 in the TpF group, 151 in the non-TpF group). SPSS software was used for univariate analyses. Results: < 0.05), and symptoms within 45 days in 57 out of 60 infants (95%). They improved their respiratory status by 14 days, and 80% of responders could be identified by 21 days after initiation. In the 18 that TpF was started for documented airway protection (airway protection group), there was a higher need for GT or TT. Conclusions: TpF could play an essential role in the management of ELBW infants with sBPD. Considering the limitations of a single center retrospective study, prospective randomized control trials are needed to confirm these findings.

Source: Frontiers in Pediatrics

DOI: 10.3389/fped.2024.1496620

Authors: Ahana Nagarkatti, Shikha Sarkar, Amirul Anuar, Naveed Hussain

Institutions: College of the Holy Cross, Connecticut Children's Medical Center

Language: English

Topic: Neonatal Respiratory Health Research

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,295