Tanaka Shinya, Namba Fumihiko, Nagaya Ken, Yonemoto Naohiro, Hirano Shinya, Yanagihara Itaru, Kitajima Hiroyuki, Fujimura Masanori
Department of Neonatology, Osaka Women's and Children's Hospital, Izumi 594-1101, Japan.
Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe 350-8550, Japan.
Biomedicines. 2024 Dec 10;12(12):2799. doi: 10.3390/biomedicines12122799.
It has been demonstrated that aspiration during endotracheal intubation in preterm infants with gastroesophageal reflux is a contributing factor in the worsening of lung diseases and the development of bronchopulmonary dysplasia (BPD). This study aims to compare the safety and efficacy of early transpyloric (TP) tube feeding with that of nasogastric (NG) tube feeding in relation to BPD.
The study population consisted of 39 extremely low birth weight infants (ELBWIs) with mechanical ventilation and an enteral feeding volume of 50 mL/kg/day, which were randomly assigned to different groups based on the method of tube feeding. The primary outcome was the incidence of adverse events.
The hazard ratio for primary adverse events was significantly lower in the TP group. The TP group had a median time of 34 days (range 24-85) and the NG group 24 days (range 13-70). In general, neither group exhibited severe intestinal complications or poor growth.
Early TP tube feeding may be a safer alternative method of NG tube feeding for intubated ELBWIs and has been shown to reduce the frequency of adverse respiratory events.
已有研究表明，患有胃食管反流的早产儿在气管插管期间发生误吸是导致肺部疾病恶化及支气管肺发育不良（BPD）发生的一个因素。本研究旨在比较早期经幽门（TP）管饲与鼻胃（NG）管饲在预防BPD方面的安全性和有效性。
研究对象为39例极低出生体重儿（ELBWI），这些患儿均接受机械通气，肠内喂养量为50 mL/（kg·天），根据管饲方法将其随机分为不同组。主要结局指标为不良事件的发生率。
TP组主要不良事件的风险比显著更低。TP组的中位时间为34天（范围24 - 85天），NG组为24天（范围13 - 70天）。总体而言，两组均未出现严重肠道并发症或生长不良情况。
对于接受插管的ELBWI，早期TP管饲可能是一种比NG管饲更安全的替代方法，且已证明可降低不良呼吸事件的发生率。
