Antecedent Predictors of Feeding Outcomes in Premature Infants With Protracted Mechanical Ventilation

J Pediatr Gastroenterol Nutr. 2015 Nov;61(5):591-5. doi: 10.1097/MPG.0000000000000867.

Abstract

Objectives: The aim of the present study was to define risk factors associated with gastrostomy in premature infants receiving protracted mechanical ventilation (≥30 days).

Methods: Retrospective data collected on 170 preterm neonates (birth weight <1500 g) who received uninterrupted mechanical ventilation for ≥30 days were analyzed with logistic regression methods to predict the association of gastrostomy with cardiorespiratory, infectious, and neurological morbidities.

Results: A total of 32 of 170 infants had gastrostomy tubes. Including all of the covariates in 1 model, duration of cumulative ventilation (P < 0.001) and uninterrupted ventilation (P < 0.001), and ventriculoperitoneal shunt (P = 0.02) were significant predictors, whereas sepsis, intraventrical hemorrhage grade III or IV, and patent ductus arteriosus ligation were not. Respiratory severity score (mean airway pressure × fraction of inspired oxygen) calculated at 30 days of life was also a significant predictor (P = 0.01).

Conclusions: In infants with protracted mechanical ventilation, the degree of respiratory support at 1 month of age, prolonged respiratory morbidity, and neuropathology are the significant predictors for gastrostomy.

MeSH terms

  • Birth Weight
  • Bronchopulmonary Dysplasia / complications
  • Bronchopulmonary Dysplasia / therapy*
  • Comorbidity*
  • Enteral Nutrition*
  • Female
  • Gastrostomy*
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Logistic Models
  • Male
  • Respiration, Artificial*
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Time Factors