The Impact of Slow Infusion Intermittent Feeding on Gavage Feeding-Associated Cardiorespiratory Deterioration in Neonatal Intensive Care Unit Infants
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Purpose: Infants in the neonatal intensive care unit (NICU) often show cardiorespiratory deterioration during gavage feeding. We aimed to determine whether slow infusion intermittent feeding (SIIF) can reduce respiratory deterioration during gavage feeding in preterm infants in the NICU. Methods: Data on preterm infants whose gavage feeding method was changed to SIIF (1-hour infusion with an infusion pump and 2-hour rest within a 3-hour interval) from bolus gravity feeding (2- or 3-hour interval) due to feeding-associated cardiorespiratory deterioration were retrospectively reviewed. A significant cardiorespiratory event was defined as a saturation level below 80% or heart rate below 80 bpm. We compared the frequency of cardiorespiratory events and the level of respiratory support 24 hours before and after the application of SIIF. Results: A total of 34 infants were enrolled and analyzed. The total frequency of desaturation or bradycardia significantly decreased after SIIF application (8.94 vs. 5.03, P=0.001). The frequency of feeding-related bradycardia and desaturation also significantly decreased (4.15 vs. 1.68, P=0.008). Out of 34 patients, 11 (32.4%) had a decreased level of ventilator support within 1 day after SIIF. The respiratory severity scores of the 10 patients who received invasive ventilator support decreased significantly after SIIF (5.24 vs. 4.59, P=0.032). Conclusion: SIIF significantly decreased gavage feeding-associated cardiorespiratory events and reduced respiratory support in approximately one-third of subjects. Therefore, SIIF may be a therapeutic option for gavage feed-associated respiratory deterioration in preterm infants in the NICU.
Abstract
Purpose: Infants in the neonatal intensive care unit (NICU) often show cardiorespiratory deterioration during gavage feeding. We aimed to determine whether slow infusion intermittent feeding (SIIF) can reduce respiratory deterioration during gavage feeding in preterm infants in the NICU. Methods: Data on preterm infants whose gavage feeding method was changed to SIIF (1-hour infusion with an infusion pump and 2-hour rest within a 3-hour interval) from bolus gravity feeding (2- or 3-hour interval) due to feeding-associated cardiorespiratory deterioration were retrospectively reviewed. A significant cardiorespiratory event was defined as a saturation level below 80% or heart rate below 80 bpm. We compared the frequency of cardiorespiratory events and the level of respiratory support 24 hours before and after the application of SIIF. Results: A total of 34 infants were enrolled and analyzed. The total frequency of desaturation or bradycardia significantly decreased after SIIF application (8.94 vs. 5.03, P=0.001). The frequency of feeding-related bradycardia and desaturation also significantly decreased (4.15 vs. 1.68, P=0.008). Out of 34 patients, 11 (32.4%) had a decreased level of ventilator support within 1 day after SIIF. The respiratory severity scores of the 10 patients who received invasive ventilator support decreased significantly after SIIF (5.24 vs. 4.59, P=0.032). Conclusion: SIIF significantly decreased gavage feeding-associated cardiorespiratory events and reduced respiratory support in approximately one-third of subjects. Therefore, SIIF may be a therapeutic option for gavage feed-associated respiratory deterioration in preterm infants in the NICU.
참고문헌 (16)
- Thoene M, "Early enteral feeding in preterm infants: a narrative review of the nutritional, metabolic, and developmental benefits", Nutrients, 13, pp.2289~ (2021)
- Blondheim O, "Effect of enteral gavage feeding rate on pulmonary functions of very low birth weight infants", J Pediatr, 122(5 Pt 1), pp.751~755 (1993)
- Ballard RA, "Inhaled nitric oxide in preterm infants undergoing mechanical ventilation", N Engl J Med, 355, pp.343~353 (2006)
- Wang Y, "Continuous feeding versus intermittent bolus feeding for premature infants with low birth weight : a meta-analysis of randomized controlled trials", Eur J Clin Nutr, 74, pp.775~783 (2020)
- Sadrudin Premji S, "Continuous nasogastric milk feeding versus intermittent bolus milk feeding for preterm infants less than 1500 grams", Cochrane Database Syst Rev, 6 (2021)
- Gonzalez JT, "Intermittent versus continuous enteral nutrition attenuates increases in insulin and leptin during short-term bed rest", Eur J Appl Physiol, 120, pp.2083~2094 (2020)
- El-Kadi SW, "Intermittent bolus feeding promotes greater lean growth than continuous feeding in a neonatal piglet model", Am J Clin Nutr, 108, pp.830~841 (2018)
- Davis TA, "Bolus vs. continuous feeding to optimize anabolism in neonates", Curr Opin Clin Nutr Metab Care, 18, pp.102~108 (2015)
- Hrdy O, "Comparison of continuous versus intermittent enteral nutrition in critically ill patients(COINN) : study protocol for a randomized comparative effectiveness trial", Trials, 21, pp.955~ (2020)
- Ichimaru S, "Diet and nutrition in critical care", pp.1~17 (2014), Springer
- Lee HY, "Continuous versus intermittent enteral tube feeding for critically ill patients: a prospective, randomized controlled trial", Nutrients, 14, pp.664~ (2022)
- O'Connor G, "Intermittent bolus versus continuous feeding in children receiving an enteral formula with food derived ingredients: a national multicentre retrospective study", Clin Nutr ESPEN, 54, pp.175~179 (2023)
- Heldt GP, "The effect of gavage feeding on the mechanics of the lung, chest wall, and diaphragm of preterm infants", Pediatr Res, 24, pp.55~58 (1988)
- Akintorin SM, "A prospective randomized trial of feeding methods in very low birth weight infants", Pediatrics, 100, pp.E4~ (1997)
- Priyadarshi A, "Continuous positive airway pressure belly syndrome : challenges of a changing paradigm", Int J Clin Pediatr, 9, pp.9~15 (2020)
- D'Angelo E, "Effects of abdominal distension on breathing pattern and respiratory mechanics in rabbits", Respir Physiol Neurobiol, 130, pp.293~304 (2002)