Predicting the need for home gavage or g-tube feeds in asphyxiated neonates treated with therapeutic hypothermia

Journal of Perinatology : Official Journal of the California Perinatal Association
Suneeti GuptaS Sarkar

Abstract

Asphyxiated infants treated with therapeutic cooling can have persistent oral feeding difficulty because of involvement of neural pathways in the brainstem, cortex, and basal ganglia. The goal is to predict the composite adverse outcome of death or persistent oral feeding difficulty using precooling/cooling attributes, and the severity and distribution of hypoxic-ischemic lesions, especially brainstem lesions on post-cooling brain magnetic resonance imaging (MRI). Retrospective review of 86 asphyxiated infants cooled from January 2006 to August 2014. Persistent feeding difficulty was defined as needing feeding support (gastrostomy tube (g-tube) or home gavage feeds) after discharge. Clinical and laboratory risk factors, and the brain MRI abnormalities including the presence of brainstem lesions were compared between infants with and without adverse outcome using univariate analysis. Significant variables were then analyzed in a stepwise logistic regression (LR) model. Infants with adverse outcome (n = 31, 4 died pre-discharge) had longer hospital stay (26 days, interquartile range (IQR) 19-43 vs. 13 days, IQR 9-20; p < 0.01) and reached goal enteral feeds (oral/gavage) later (11 days vs. 8 days, p < 0.01) compared to 55 infants...Continue Reading

References

Oct 1, 1987·American Journal of Diseases of Children·D B Nelson, J S Garland
Oct 14, 2005·The New England Journal of Medicine·Seetha ShankaranUNKNOWN National Institute of Child Health and Human Development Neonatal Research Network
Nov 3, 2006·Pediatrics·Namasivayam AmbalavananUNKNOWN National Institute of Child Health and Human Development Neonatal Research Network
Apr 6, 2011·Archives of Pediatrics & Adolescent Medicine·Susan E JacobsUNKNOWN Infant Cooling Evaluation Collaboration
Apr 30, 2011·Journal of Perinatology : Official Journal of the California Perinatal Association·S SarkarS M Donn
Jun 5, 2012·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Miriam Martinez-BiargeFrances M Cowan
Aug 31, 2012·Archives of Disease in Childhood. Fetal and Neonatal Edition·Subrata SarkarJohn D Barks
Feb 2, 2013·Journal of Perinatology : Official Journal of the California Perinatal Association·S SarkarS M Donn

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Citations

Nov 24, 2020·Journal of Perinatology : Official Journal of the California Perinatal Association·Siddhartha Sean SarkarSubrata Sarkar
Mar 4, 2021·American Journal of Perinatology·Mrinmayee TakleJennifer Burnsed

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