fbpx
You Are Reading

Research: Factors and Growth Trends Associated with the Need for Gastrostomy Tube in Neonates with Congenital Diaphragmatic Hernia

0
Uncategorized

Research: Factors and Growth Trends Associated with the Need for Gastrostomy Tube in Neonates with Congenital Diaphragmatic Hernia

J Pediatr Gastroenterol Nutr

. 2021 Jun 10. doi: 10.1097/MPG.0000000000003203. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/34117194/

Factors and Growth Trends Associated with the Need for Gastrostomy Tube in Neonates with Congenital Diaphragmatic Hernia

Marisa E Schwab 1Shannon BurkeMary Kate KlarichLan T VuAffiliations expand

Abstract

Objectives: A third of infants with congenital diaphragmatic hernia (CDH) require a gastrostomy tube (GT) for nutritional support. We compared CDH infants who are GT-dependent to those able to meet their nutritional needs orally, to identify factors associated with requiring a GT and evaluate their long-term growth.

Methods: Patients with CDH repaired at a single institution between 2012-2020 were included. Charts were retrospectively reviewed for demographic, surgical, and post-operative details. Mann-Whitney test and Fischer’s exact test were performed to compare GT-dependent neonates (n = 38, experimental) with orally fed neonates (n = 63, control). Significance was set at <0.05.

Results: Thirty-eight percent received a GT (median 67 days, IQR 50-88). GT-dependent neonates were significantly more likely to have a lower lung-to-head ratio (median 1.2, IQR 0.9-1.4, vs 1.6, IQR 1.3-2.0, IQR p < 0.0001), undergone patch or flap repair (79% vs 33%, p < 0.0001), and been hospitalized longer (median 47, IQR 24-75) vs 28 days, p < 0.0001). 14/38 had their GT removed (median 26 months, IQR 14-36). GT-dependent neonates initiated oral feeds (calculated as time since extubation) later (median 21, IQR 8-26, vs 8 days, IQR 4-13, p = 0.006). Height-for-age z-scores remained stable after GT removal, while weight-for-age z-scores dropped initially and began improving a year later.

Conclusions: The need for a gastrostomy for nutritional support is associated with more severe CDH. Over a third of patients no longer needed a GT at a median of 26 months. Linear growth generally remains stable after removal. These results may help counsel parents regarding nutritional expectations.

An infographic is available for this article at:http://links.lww.com/MPG/C381.

cuevana 3

Follow @ Instagram

Translate »

TasteKid.com provides Menu of different Restaurant. Now get all Restaurant Menu, Prices, Catering, Near Me locations, Open Hours. You can quickly find Near me Restaurants around your place.

123 movies soap2day