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Continuous gastric drip versus intravenous fluids in low birthweight infants
M Becerra1, J Cifuentes, M I Saldfas
1Department of Pediatrics, Universidad Católica de Chile, Santiago.
Insights
Continuous gastric drip (CGD) feeding for healthy newborns reduces the need for intravenous (IV) lines. This method of fluid administration did not increase complications or the risk of feeding intolerance in the study group.
Area of Science:
- Neonatalogy
- Pediatric Gastroenterology
- Clinical Nutrition
Background:
- Intravenous (IV) fluid administration is common in neonatal care for infants requiring fluid support.
- Alternative methods for fluid and nutrient delivery are sought to minimize invasive procedures.
Purpose of the Study:
- To compare the efficacy and safety of continuous gastric drip (CGD) versus intravenous (IV) fluid administration in healthy newborns.
- To determine if CGD reduces the requirement for IV lines without compromising infant well-being.
Main Methods:
- A multicentre randomized study involving healthy newborns (birthweight 1501-2000 g) requiring IV fluids.
- Infants were randomized to receive either CGD or IV fluids before the second hour of life.
- Key outcomes included the need for IV lines, serum glucose, electrolytes, feeding intolerance, and IV line complications.
Main Results:
- Only 10% of infants in the CGD group required IV fluids, with 90% receiving nutrients via orogastric tube.
- No significant differences were observed in the incidence of hypoglycemia, hyponatremia, or feeding intolerance between the CGD and IV groups.
- The number of venous lines and IV line-related complications were comparable or reduced in the CGD group.
Conclusions:
- Continuous gastric drip (CGD) is an effective method for fluid and nutrient delivery in eligible newborns.
- CGD significantly reduces the need for intravenous lines in this population.
- This approach does not appear to increase the risk of common neonatal complications such as hypoglycemia, hyponatremia, or feeding intolerance.
Unlabelled:
This multicentre randomized study compared a continuous gastric drip (CGD) with intravenous (i.v.) fluid administration. Healthy newborns with birthweight from 1501 to 2000 g whose physician ordered i.v. fluids were randomized before the 2nd hour of life to CGD or i.v. fluids. The major outcome variable was the need for an i.v. line in the CGD group. Serum glucose was measured at 30 min, 1 h and every 6 h thereafter. Serum sodium and potassium were measured at least once during the first 72 h of life. Enteral feedings, feeding intolerance, number of venous lines and i.v. line-related complications were recorded until the interruption of CGD or the i.v. line. Twenty-nine infants were randomized to each group. The two groups were comparable in terms of birthweight and gestational age. Ten percent (3/29) of the infants randomized to the CGD group required i.v. fluids and 90% of them received electrolytes and glucose through an orogastric tube. The incidence of hypoglycaemia, hyponatraemia and episodes of feeding intolerance did not differ between the groups.
Conclusion:
Fluid administration by CGD reduces the need for i.v. lines without increasing the risk of complications.