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Licensed Unlicensed Requires Authentication Published by De Gruyter November 11, 2020

Acute respiratory effect of transpyloric feeding for respiratory exacerbation in preterm infants

  • Tomoyuki Shimokaze ORCID logo EMAIL logo , Kouji Yamamoto ORCID logo , Yoshihisa Miyamoto , Katsuaki Toyoshima ORCID logo , Kaoru Katsumata and Tomoko Saito

Abstract

Objectives

Gastroesophageal reflux may exacerbate chronic lung disease in preterm infants. We evaluated the short-term effects of transpyloric feeding on respiratory status in preterm infants during mechanical ventilation.

Methods

We retrospectively collected data from the hospital information management system. To evaluate the effect of transpyloric feeding on oxygenation, we compared changes in SpO2/FiO2 ratios before and after commencing transpyloric feeding by a piecewise linear regression model.

Results

We examined 33 infants (median gestational age, 25.4 weeks; median birth weight, 656 g) who underwent transpyloric feeding. All tubes were placed at the bedside without fluoroscopy. No cases of unsuccessful placement, gastroduodenal perforation, or tracheal misinsertion occurred. Transpyloric feeding began at a median age of 18 (interquartile range, 15–23) days. Mean SpO2/FiO2 (±SD) ratios were 391 (±49), 371 (±51), 365 (±56), and 366 (±53) 72–96 h before, 0–24 h before, 48–72 h after, and 96–120 h after starting transpyloric feeding, respectively. The rate of change per hour of SpO2/FiO2 ratios increased 48–120 h after compared with 0–96 h before transpyloric feeding (0.03 [95% confidence interval, −0.10 to 0.17] vs. −0.29 [−0.47 to −0.12]) (p=0.007). No apparent changes occurred in the mean airway pressure, amplitude pressure, or pCO2.

Conclusions

Transpyloric feeding during mechanical ventilation can prevent the deterioration of oxygenation without major complications at the stage of respiratory exacerbation in preterm infants.


Corresponding author: Tomoyuki Shimokaze, MD, Department of Neonatology, Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan, Phone: +81 45 7112351, Fax: +81 45 7213324, E-mail:

Acknowledgments

We thank Hugh McGonigle, from Edanz Group (www.edanzediting.com/ac), for editing a draft of the manuscript.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: This study was approved by the institutional review board of Kanagawa Children’s Medical Center (No. 1807–8, 4 February 2019).

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Received: 2020-05-29
Accepted: 2020-09-22
Published Online: 2020-11-11
Published in Print: 2021-03-26

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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