Neonatal Nutrition and Gastroenterology Program, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
J Pediatr. 2022 Jul;246:26-33.e2. doi: 10.1016/j.jpeds.2022.03.012. Epub 2022 Mar 14.
To examine rates and determinants of home nasogastric (NG)-tube feeding at hospital discharge in a cohort of very preterm infants within the Canadian Neonatal Network (CNN).
This was a population-based cohort study of infants born <33 weeks of gestation and admitted to neonatal intensive care units (NICUs) participating in the CNN between January 1, 2010, and December 31, 2018. We excluded infants who had major congenital anomalies, required gastrostomy-tube, or were discharged to non-CNN facilities. Multivariable logistic regression analysis was used to identify independent determinants of home NG-tube feeding at hospital discharge.
Among the 13 232 infants born very preterm during the study period, 333 (2.5%) were discharged home to receive NG-tube feeding. Rates of home NG-tube feeding varied across Canadian NICUs, from 0% to 12%. Determinants of home NG-tube feeding were gestational age (aOR 0.94 per each gestational week increase, 95% CI 0.88-0.99); duration of mechanical ventilation (aOR 1.02 per each day increase, 95% CI 1.01-1.02); high illness severity at birth (aOR 1.32, 95% CI 1.01-1.74); small for gestational age (aOR 2.06, 95% CI 1.52-2.78); male sex (aOR 0.61, 95% CI 0.49-0.77); severe brain injury (aOR 1.60, 95% CI 1.10-2.32); and bronchopulmonary dysplasia (aOR 2.22, 95% CI 1.67-2.94).
Rates of home NG-tube feeding varied widely between Canadian NICUs. Higher gestational age and male sex reduced the odds of discharge home to receive NG-tube feeding; and in contrast small for gestational age, severe brain injury, prolonged duration on mechanical ventilation and bronchopulmonary dysplasia increased the odds.
在加拿大新生儿网络（CNN）中，对小早产儿队列出院时进行家庭鼻胃（NG）管喂养的比率和决定因素进行研究。
这是一项基于人群的队列研究，纳入 2010 年 1 月 1 日至 2018 年 12 月 31 日期间在 CNN 参与的新生儿重症监护病房（NICU）中接受治疗的出生胎龄<33 周的婴儿。排除存在重大先天性畸形、需要胃造口管或出院至非 CNN 机构的婴儿。采用多变量逻辑回归分析确定出院时家庭 NG 管喂养的独立决定因素。
在研究期间出生的 13232 名非常早产儿中，有 333 名（2.5%）出院回家接受 NG 管喂养。加拿大各 NICU 家庭 NG 管喂养率差异很大，从 0%到 12%不等。家庭 NG 管喂养的决定因素包括胎龄（每增加 1 周，OR 0.94，95%CI 0.88-0.99）；机械通气时间（每增加 1 天，OR 1.02，95%CI 1.01-1.02）；出生时疾病严重程度高（OR 1.32，95%CI 1.01-1.74）；小于胎龄儿（OR 2.06，95%CI 1.52-2.78）；男性（OR 0.61，95%CI 0.49-0.77）；严重脑损伤（OR 1.60，95%CI 1.10-2.32）；和支气管肺发育不良（OR 2.22，95%CI 1.67-2.94）。
加拿大各 NICU 之间家庭 NG 管喂养率差异很大。较高的胎龄和男性降低了出院接受 NG 管喂养的几率；而相反，小于胎龄儿、严重脑损伤、机械通气时间延长和支气管肺发育不良增加了这一几率。
