Cox Emily, Chawla Jasneek, Moore Madison, Schilling Sandra, Cameron Miriam, Clarke Sally, Johnstone Chelsea, Marshall Jeanne
School of Clinical Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Respiratory Department, Queensland Children's Hospital and Health Service, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2024 Dec;60(12):796-802. doi: 10.1111/jpc.16679. Epub 2024 Sep 30.
To characterise the feeding profile and care pathway for infants receiving prolonged high-flow nasal cannula (HFNC) respiratory support for management of a chronic condition at one facility from January to December 2021.
Data regarding medical history, HFNC admission details (reason for HFNC, HFNC duration, flow rate), feeding outcomes and speech pathology care were collected from electronic records of HFNC-dependent infants (requiring HFNC ≥2-3 L/kg for ≥5 consecutive days). Infants with acute respiratory conditions (e.g. bronchiolitis) were excluded.
This study included 24 participants (median corrected age at admission 5.3 weeks, range -6 to 18.6). Of these, 15 (60%) had a condition/s that affected more than one body system (e.g. congenital diaphragmatic hernia), requiring the care of multiple specialities. Median length of HFNC use was 37.5 days (range 11-188). Twenty (83.3%) infants were referred for speech pathology (SLP) input while on HFNC support. For those referred, frequency of SLP input was variable (0-3 sessions/week), and HFNC support requirements were the most common barrier to SLP intervention (n = 9, 45%). Twelve (54.5%) infants demonstrated improvement in their primary feeding method by discharge; however, only two (9.1%) infants were discharged on full oral feeds.
This study demonstrates variability in oral feeding management in infants with prolonged HFNC-dependence at our centre. Respiratory support with HFNC was identified as a barrier to progressing oral feeding. Further research is required to determine if oral feeding can be safely undertaken in this cohort. This is imperative to ensure that long-term feeding outcomes are not negatively impacted by current practice.
描述2021年1月至12月期间在某机构接受长期高流量鼻导管（HFNC）呼吸支持以治疗慢性病的婴儿的喂养情况和护理路径。
从依赖HFNC的婴儿（连续≥5天需要HFNC≥2-3 L/kg）的电子记录中收集病史、HFNC入院详情（HFNC的原因、HFNC持续时间、流速）、喂养结果和言语病理学护理等数据。排除患有急性呼吸道疾病（如细支气管炎）的婴儿。
本研究纳入了24名参与者（入院时矫正年龄中位数为5.3周，范围为-6至18.6周）。其中，15名（60%）患有影响多个身体系统的疾病（如先天性膈疝），需要多个专科的护理。HFNC使用的中位数时长为37.5天（范围为11-188天）。20名（83.3%）婴儿在接受HFNC支持期间被转介接受言语病理学（SLP）干预。对于那些被转介的婴儿，SLP干预的频率各不相同（0-3次/周），而HFNC支持需求是SLP干预最常见的障碍（n=9，45%）。12名（54.5%）婴儿在出院时主要喂养方式有所改善；然而，只有2名（9.1%）婴儿出院时完全经口喂养。
本研究表明，在我们中心，长期依赖HFNC的婴儿在经口喂养管理方面存在差异。HFNC呼吸支持被认为是经口喂养进展的障碍。需要进一步研究以确定该队列中的婴儿是否可以安全地进行经口喂养。这对于确保长期喂养结果不受当前做法的负面影响至关重要。
