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

Tomoyuki Shimokaze1, Kouji Yamamoto2, Yoshihisa Miyamoto3

  • 1Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan.

Journal of Perinatal Medicine
|November 11, 2020
PubMed

Insights

Transpyloric feeding in preterm infants on mechanical ventilation improved oxygenation. This method prevented respiratory deterioration without significant complications, offering a safe intervention for fragile newborns.

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Medicine
  • Critical Care

Background:

  • Gastroesophageal reflux is a known exacerbating factor for chronic lung disease in preterm infants.
  • Mechanical ventilation is often required for respiratory support in these vulnerable infants.
  • Optimizing nutritional support while managing respiratory status is crucial for preterm infants.

Purpose of the Study:

  • To evaluate the short-term effects of transpyloric feeding on the respiratory status of preterm infants.
  • To assess the impact of transpyloric feeding on oxygenation in mechanically ventilated preterm infants.
  • To determine the safety and efficacy of transpyloric feeding in preventing respiratory deterioration.

Main Methods:

  • Retrospective data collection from a hospital information management system.
  • Comparison of pre- and post-feeding SpO2/FiO2 ratios using piecewise linear regression.
  • Analysis of respiratory parameters including mean airway pressure, amplitude pressure, and pCO2.

Main Results:

  • Thirty-three preterm infants (median gestational age 25.4 weeks) were included.
  • Transpyloric feeding was initiated at a median age of 18 days without major placement complications.
  • Oxygenation (SpO2/FiO2 ratios) showed a significant improvement 48-120 hours after initiating transpyloric feeding (p=0.007).

Conclusions:

  • Transpyloric feeding can effectively prevent oxygenation deterioration in preterm infants experiencing respiratory exacerbations.
  • This feeding method appears safe, with no major complications reported during the study period.
  • Transpyloric feeding is a viable strategy for managing respiratory status in mechanically ventilated preterm infants.
Abstract

Keywords:
SpO2/FiO2 ratioaspirationchronic lung diseasegastric feedinggastroesophageal reflux

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