ABSTRACT
BACKGROUND: Preterm infants are fed by orogastric / nasogastric tube until they reach maturation and coordination of sucking, swallowing and respiration at approximately 32-34 weeks of corrected age. While being on non-invasive ventilation (NIV), they frequently present abdominal distension. Currently at our institution two techniques are used for the management of abdominal distension in preterm infants fed by bolus via orogastric tube: cenit and 2 x 1.The aim of this study was to compare the proportion of preterm infants presenting NIV-associated abdominal distension with each of these techniques. STUDY DESIGN: We conducted a randomized clinical trial including infants ofâ< â36.6 weeks of gestation andâ< â1500âg of birth weight who were admitted to our NICU during the period of April 1, 2016 to April 1, 2018 and received NIV. The presence of abdominal distensionâ> â2âcm was the primary outcome. Secondary outcomes were presence of reflux, regurgitation, oxygen saturation during feeding and days to reach full feedings. Feeding tube drainage, stool characteristics and the use of prokinetics were confounding variables. RESULTS: A total of 97 patients were included. Forty-six in the cenit group and 51 in the 2 x 1 group. There was no difference in the proportion of infants with abdominal distensionâ> â2âcm between groups. Oxygen saturation during feeding at volume of 150âml/kg/day was higher in the cenit group with statistical significance. CONCLUSION: The use of cenit or 2 x 1 technique in preterm infants with NIV did not improve abdominal distension or other indicators of feeding tolerance.
Subject(s)
Enteral Nutrition , Gastrointestinal Motility , Infant, Newborn, Diseases , Infant, Premature/growth & development , Intestinal Diseases , Noninvasive Ventilation , Child Development/physiology , Drainage/methods , Enteral Nutrition/instrumentation , Enteral Nutrition/methods , Female , Gastrointestinal Agents/therapeutic use , Humans , Infant, Newborn , Infant, Newborn, Diseases/physiopathology , Infant, Newborn, Diseases/prevention & control , Infant, Premature/physiology , Intestinal Diseases/physiopathology , Intestinal Diseases/prevention & control , Intubation, Gastrointestinal/adverse effects , Intubation, Gastrointestinal/methods , Male , Noninvasive Ventilation/adverse effects , Noninvasive Ventilation/methods , Treatment Outcome , Weight GainABSTRACT
Propofol infusion syndrome (PRIS) is a rare syndrome originally described in critically ill children undergoing long-term (> 48 h) propofol infusion at high doses (> 4 mg/kg/h). Severe metabolic acidosis, rhabdomyolysis, renal failure and fatal cardiac failure are the features. Herein, we present a case of a newborn who developed PRIS after a single bolus dose of propofol at 3.2 mg/kg/do, developing rhabdomyolysis and severe metabolic acidosis, with a successful outcome after medical therapy.
