Antecedent Predictors of Feeding Outcomes in Premature Infants With Protracted Mechanical Ventilation.

OBJECTIVES

The aim of the present study was to define risk factors associated with gastrostomy in premature infants receiving protracted mechanical ventilation (≥30 days).

METHODS

Retrospective data collected on 170 preterm neonates (birth weight <1500 g) who received uninterrupted mechanical ventilation for ≥30 days were analyzed with logistic regression methods to predict the association of gastrostomy with cardiorespiratory, infectious, and neurological morbidities.

RESULTS

A total of 32 of 170 infants had gastrostomy tubes. Including all of the covariates in 1 model, duration of cumulative ventilation (P < 0.001) and uninterrupted ventilation (P < 0.001), and ventriculoperitoneal shunt (P = 0.02) were significant predictors, whereas sepsis, intraventrical hemorrhage grade III or IV, and patent ductus arteriosus ligation were not. Respiratory severity score (mean airway pressure × fraction of inspired oxygen) calculated at 30 days of life was also a significant predictor (P = 0.01).

CONCLUSIONS

In infants with protracted mechanical ventilation, the degree of respiratory support at 1 month of age, prolonged respiratory morbidity, and neuropathology are the significant predictors for gastrostomy.