Evaluation of gastroschisis feeding protocol: A retrospective cohort study.

IF 1.6 4区 医学 Q2 PEDIATRICS
Jeewan Jyoti, Kristen James-Nunez, Kaye Spence, Brownyn Parkinson, Gordon Thomas, Amit Trivedi
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引用次数: 0

Abstract

Aim: The primary objective of this study is to determine the impact of a standardised feeding protocol for infants with gastroschisis on early enteral feeds, suck feeds, management of gastric residuals and breastfeeding at discharge. Secondary objectives were evaluation of growth, length of stay in neonatal intensive care unit (NICU), the duration of total parental nutrition (TPN), blood-culture confirmed sepsis and serum bilirubin level (SBR).

Methods: This single-centre retrospective quality improvement project included infants admitted to a quaternary care NICU for management of gastroschisis from 2010 to 2021. The Gastroschisis feeding protocol, a standardised pathway for managing the feeding of infants with gastroschisis, was implemented in this NICU in 2016. The outcomes of infants in the pre-feeding protocol and post-feeding protocol groups were compared.

Results: Of the 100 infants included in the study, 49 were in the post-feeding protocol group. The baseline characteristics of the study population did not differ statistically in both groups. In post-feeding protocol group, there was significant reduction in the time to the first enteral feed (P value <0.0001) and first suck feed (P value = 0.002). The median length of stay in the post-feeding protocol group was significantly lower by 11 days (P value = 0.001). Duration of TPN was 241 h higher in the pre-feeding protocol group (P value 0.0007).

Conclusions: Implementation of a feeding protocol in infants with gastroschisis led to earlier initiation of enteral feeds and suck feeds. There is a likelihood of reduction in the use of TPN and duration of admission in NICU.

评估胃裂喂养方案:回顾性队列研究
目的:本研究的主要目的是确定标准化喂养方案对胃裂婴儿早期肠内喂养、吸吮喂养、胃残余物管理和出院时母乳喂养的影响。次要目标是评估生长情况、新生儿重症监护室(NICU)住院时间、全母乳喂养(TPN)持续时间、血液培养证实的败血症和血清胆红素水平(SBR):该单中心回顾性质量改进项目包括2010年至2021年期间入住四级护理新生儿重症监护室接受胃裂治疗的婴儿。2016年,该新生儿重症监护室实施了胃螺裂喂养方案,这是管理胃螺裂婴儿喂养的标准化路径。我们比较了喂养前和喂养后两组婴儿的结果:在纳入研究的 100 名婴儿中,49 名属于喂养方案实施后组。两组研究对象的基线特征无统计学差异。后喂养方案组中,首次肠内喂养的时间明显缩短(P 值):对患有胃裂的婴儿实施喂养方案后,可以更早地开始肠内喂养和吸吮喂养。使用 TPN 和入住新生儿重症监护室的时间有可能缩短。
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来源期刊
CiteScore
2.90
自引率
5.90%
发文量
487
审稿时长
3-6 weeks
期刊介绍: The Journal of Paediatrics and Child Health publishes original research articles of scientific excellence in paediatrics and child health. Research Articles, Case Reports and Letters to the Editor are published, together with invited Reviews, Annotations, Editorial Comments and manuscripts of educational interest.
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