Abstract:
Background : Premature infants who cannot achieve full oral
feeds may need a gastrostomy tube (GT) to be discharged from the
neonatal intensive care unit (NICU). We previously developed a model to
predict which infants born <30 weeks (w) gestational age (GA)
will require a GT before discharge. Here we report the detailed
respiratory variable data to describe the general respiratory course for
infants in the NICU <30w GA at birth and the association
between different levels of respiratory support with postmenstrual age
(PMA) at the time of first oral feeding attempt (PMAff), including later
need for GT for discharge.
Methods : Retrospective chart review of 391 NICU admissions
comprising test (2015-2016) and validation (2017-2018) cohorts. Data,
including respiratory support, were collected on 204 infants, 41 GT and
163 non-GT, in the test cohort, and 187 infants, 37 GT and 150 non-GT,
in the validation cohort.
Results : Respiratory data were significantly different between
GT and non-GT infants. Infants who required GT for discharge were on
significantly higher respiratory support at 30 days of age, 32w PMA and
36w PMA. Respiratory parameters were highly correlated with PMAff.
Conclusion : Respiratory status predicts PMAff, which was the
variable in our previously described model that was most predictive of
failure to achieve full oral feeing. These data provide a catalyst to
develop strategies for improving oral feeding outcome for infants
requiring prolonged respiratory support in the NICU.