Effectiveness of a Novel Feeding Algorithm for Oral Feeding Transition of Infants Born Prematurely.

IF 1.6 4区 医学 Q2 NURSING
Kelly Laborde, Nanette Gremillion, Jeannie Harper, Andrew G Chapple, Ashley Deaton, Allison Yates, Steven Spedale, Elizabeth Sutton
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Abstract

Background: Feeding skill acquisition is commonly a limiting factor determining when an infant born prematurely can be discharged.

Purpose: This study aimed to determine if the addition of a novel feeding progression algorithm (combination of objective data from a suck measurement device and slow flow/low variability nipples) to current neonatal intensive care unit (NICU) standards could decrease feeding-related length of stay (primary outcome). We hypothesized that by timing the initiation of oral feedings to coincide with adequate sensory-motor skill development, feeding-related length of stay may be decreased.

Methods: This was a prospective intervention study, with a historical control cohort, of infants born less than 30 weeks' gestational age without comorbidities affecting feeding skill acquisition at a Regional Level III-S NICU at a women and infant's hospital in Louisiana. A novel feeding progression algorithm utilized objective assessment of sucking to determine progression in nipple flow rates with slow flow/low variability nipples (flow rates from 0 to 9 mL/min) for infants receiving intervention (n = 18). Thirty-six controls who did not receive the feeding progression algorithm were identified via electronic medical record retrospective chart review.

Results: Eighteen completed the study. Compared to the control group, infants receiving feeding interventions had delayed sequencing initiation, extended time between initially off positive pressure ventilation and initiation of sequencing, and decreased feeding-related length of stay, with similar total length of stay.

Implications for practice and research: This study adds to existing research supporting the effectiveness of novel feeding progression algorithms and interventions to support the health and outcomes of infants born prematurely. Future research should focus on implementation studies for feeding progression algorithm integration into standard NICU care.

新型喂养算法对早产儿口服喂养过渡的有效性
背景:目的:本研究旨在确定在现行新生儿重症监护室(NICU)标准的基础上增加新的喂养进展算法(结合吸吮测量设备和低流量/低变异性乳头的客观数据)能否缩短与喂养相关的住院时间(主要结果)。我们假设,在新生儿感官-运动技能充分发展的同时开始口喂,可以缩短与喂养相关的住院时间:这是一项前瞻性干预研究,研究对象为路易斯安那州一家妇婴医院的地区三级重症监护室中胎龄不足 30 周且无影响喂养技能掌握的合并症的婴儿。一种新的喂养进展算法利用对吸吮的客观评估来确定接受干预的婴儿(n = 18)使用慢流量/低变异性乳头(流量从 0 到 9 mL/min)时乳头流量的进展情况。通过电子病历回顾,确定了 36 名未接受喂养进展算法的对照组:结果:18 人完成了研究。与对照组相比,接受喂养干预的婴儿开始排序的时间推迟了,从开始关闭正压通气到开始排序的时间延长了,与喂养相关的住院时间缩短了,总住院时间相近:本研究是对现有研究的补充,这些研究支持新型喂养进展算法和干预措施对早产儿健康和预后的有效性。未来的研究应侧重于将喂养进展算法纳入标准新生儿重症监护室护理的实施研究。
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来源期刊
CiteScore
2.60
自引率
5.90%
发文量
101
期刊介绍: Advances in Neonatal Care takes a unique and dynamic approach to the original research and clinical practice articles it publishes. Addressing the practice challenges faced every day—caring for the 40,000-plus low-birth-weight infants in Level II and Level III NICUs each year—the journal promotes evidence-based care and improved outcomes for the tiniest patients and their families. Peer-reviewed editorial includes unique and detailed visual and teaching aids, such as Family Teaching Toolbox, Research to Practice, Cultivating Clinical Expertise, and Online Features. Each issue offers Continuing Education (CE) articles in both print and online formats.
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