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Oral versus nasal route for placing feeding tubes: no effect on hypoxemia and bradycardia in infants with apnea of prematurity.
MedLine Citation:
PMID:  20234138     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Raised upper airway resistance may be involved in apnea of prematurity (AOP). OBJECTIVES: To determine the effects of an oral versus a nasal gastric tube on episodes of hypoxemia and bradycardia in infants with AOP. METHODS: In a randomized controlled cross-over trial, 32 infants (median gestational age 29 (range 24-31) weeks, postmenstrual age at study 32 (range 30-35) weeks) with the need for tube feeding and symptoms of AOP underwent a 24-hour recording of breathing movements, nasal airflow, heart rate, pulse oximeter saturation and pulse waveforms. A 5-Fr feeding tube was placed orally or nasally for 12 h each, the position selected first was randomly assigned. When the feeding tube was placed nasally, always the smaller nostril was selected. Each infant acted as his/her own control. Recordings were analyzed for the summed rate of bradycardia and desaturation (heart rate <2/3 of baseline, saturation <or=80%). RESULTS: The route of placing the feeding tube had no significant effect on the summed rate of bradycardia and desaturation (nasal route: median 1.6, CI 0.8-1.9; oral route: median 1.0, CI 0.9-1.6, p = 0.25). CONCLUSION: We could not confirm an advantage of placing a feeding tube orally in these infants with AOP, as the oral route did not improve their symptoms of AOP. Possible explanations include: (i) the increase in nasal airway resistance by the 5-Fr nasogastric tube, inserted into the smaller nostril, is too small to have any effect on AOP; (ii) any benefit of the oral route is neutralized by the negative effects of an enhanced vagal stimulation, or (iii) study duration was too short to detect a difference in AOP.
Authors:
Bettina Bohnhorst; Kathrin Cech; Corinna Peter; Michael Doerdelmann
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Publication Detail:
Type:  Journal Article     Date:  2010-03-16
Journal Detail:
Title:  Neonatology     Volume:  98     ISSN:  1661-7819     ISO Abbreviation:  Neonatology     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  143-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 S. Karger AG, Basel.
Affiliation:
Department of Pediatric Pulmonology and Neonatology, Hannover Medical School, Hannover, Germany. bohnhorst.bettina@mh-hannover.de
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