Ermarth Anna, Brinker Kristin, Ostrander Betsy
University of Utah School of Medicine, Salt Lake City, UT, USA; Division of Pediatric Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, USA.
Primary Children's Hospital, Intermountain Health, Salt Lake City, UT, USA.
Early Hum Dev. 2023 Dec;187:105879. doi: 10.1016/j.earlhumdev.2023.105879. Epub 2023 Oct 19.
Patients admitted to the neonatal intensive care unit (NICU) have higher association for neurodevelopment deficits, specifically cerebral palsy (CP). We identified patients with risk for CP using abnormal Pretchl's General Movement Assessment (GMA) and sub-category of cramped synchronized movements (CSM) and reported their feeding outcomes at discharge. Over 75 % of these patients required either nasogastric (NGT) or gastrostomy tube (GT) at discharge. Of these, 57 % weaned off their NGT or GT at home and 43 % of patients still needed a GT one year after discharge. Of those that could not wean off their NGT or GT, these patients had longer hospital stay, took lower percentage by mouth, and an older post-menstrual age at discharge. We did not find a difference in NGT or GT use between patients with IVH, ELBW, nor between their birthweight or gestation age at birth. This study provides further clinical characteristics in NICU patients who have higher risk of CP, and supports the need for skilled feeding therapy and resources both during and after NICU admission.
入住新生儿重症监护病房（NICU）的患者出现神经发育缺陷尤其是脑瘫（CP）的关联度更高。我们通过异常的普雷茨尔全身运动评估（GMA）和痉挛同步运动（CSM）子类别来识别有患CP风险的患者，并报告了他们出院时的喂养结果。超过75%的这些患者出院时需要鼻胃管（NGT）或胃造瘘管（GT）。其中，57%的患者在家中停用了NGT或GT，43%的患者出院一年后仍需要GT。在那些无法停用NGT或GT的患者中，这些患者住院时间更长，经口摄入量百分比更低，出院时的月经后年龄更大。我们未发现IVH、极低出生体重儿（ELBW）患者之间在使用NGT或GT方面存在差异，也未发现他们出生时的体重或胎龄之间存在差异。本研究提供了患CP风险较高的NICU患者的进一步临床特征，并支持在NICU住院期间及出院后都需要专业的喂养治疗和资源。
