Link: http://www.ncbi.nlm.nih.gov/pubmed/27559682

Early Hum Dev. 2016 Aug 22;103:97-100. doi: 10.1016/j.earlhumdev.2016.08.003. [Epub ahead of print]
Gastrostomy tube placement in infants with congenital diaphragmatic hernia: Frequency, predictors, and growth outcomes.
Rudra S1, Adibe OO2, Malcolm WF3, Smith PB4, Cotten CM5, Greenberg RG6.
Author information

Abstract
BACKGROUND:
Gastrostomy tube (G-tube) placement is a common intervention for newborns with severe feeding difficulties. Infants with congenital diaphragmatic hernia (CDH) are at high risk for feeding problems. Prevalence of G-tube placement and consequent nutritional outcomes of infants with CDH and G-tubes has not been described.
AIMS:
Determine factors associated with G-tube placement and growth in infants with congenital diaphragmatic hernia.
STUDY DESIGN:
Retrospective cohort study of infants with CDH to evaluate the association of G-tube placement with risk factors using logistic regression. We also assessed the association between growth velocity and G-tube placement and other risk factors using linear regression.
SUBJECTS:
The subjects of the study were infants with CDH treated at Duke University Medical Center from 1997 to 2013.
OUTCOME MEASURES:
Weight gain in infants with CDH that had G-tube placement compared to those infants with CDH that did not.
RESULT:
Of the 123 infants with CDH, 85 (69%) survived and G-tubes were placed in 25/85 (29%) survivors. On adjusted analysis, extracorporeal membrane oxygenation (OR=11.26 [95% CI: 1.92-65.89]; P=0.01) and proton pump inhibitor use (OR=17.29 [3.98-75.14], P≤0.001) were associated with G-tube placement. Infants without G-tubes had a growth velocity of 6.5g/day (95% CI: 2.5-10.4) more than infants with G-tubes.
CONCLUSION:
Survivors with more complex inpatient courses were more likely to receive G-tubes. Further investigation is needed to identify optimal feeding practices for infants with CDH.
Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
KEYWORDS:
Feeding; G-tube; Neonate
PMID: 27559682 DOI: 10.1016/j.earlhumdev.2016.08.003
[PubMed - as supplied by publisher]
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