Nasogastric vs Orogastric Feeding in Stable Preterm (≤32 Weeks) Neonates: A Randomized Open-Label Controlled Trial.

Area of Science:

• Neonatal Medicine
• Pediatric Gastroenterology
• Clinical Nutrition

Background:

• The optimal route for tube feeding in preterm infants remains undetermined.
• Preterm neonates are susceptible to cardiorespiratory events during feeding interventions.

Purpose of the Study:

• To compare the incidence of bradycardia and desaturation episodes per hour between nasogastric and orogastric tube feeding in hemodynamically stable preterm neonates.
• To evaluate the safety and efficacy of different tube feeding routes in premature infants.

Main Methods:

• A randomized controlled trial was conducted involving hemodynamically stable preterm neonates (≤32 weeks gestational age) requiring tube feeding.
• Feeding tube insertion episodes (FTIEs) were monitored, with each nasogastric or orogastric tube insertion counted as a separate episode.
• The primary outcome measured was the number of bradycardia and desaturation episodes per hour during the time the tube was in situ.

Main Results:

• A statistically significant higher mean number of bradycardia and desaturation episodes per hour was observed with the nasogastric route compared to the orogastric route (mean difference: 0.144; 95% CI: 0.067-0.220; P<0.001).
• 160 FTIEs were analyzed, with 80 in neonates <30 weeks and 80 in those ≥30 weeks gestational age.

Conclusions:

• The orogastric route of tube feeding may be preferable to the nasogastric route in hemodynamically stable preterm neonates.
• Findings suggest that orogastric feeding could potentially reduce cardiorespiratory disturbances in this population.