S Y Shiao1, J Brooker, T DiFiore. 1. Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106-4904, USA.
Abstract
OBJECTIVE: To examine the desaturation events with the presence and absence of a nasogastric tube during an entire oral feeding in 20 very low birth weight (VLBW) infants. DESIGN: Prospective, quasi-experimental, random assignment. SETTING:Midwestern, university-affiliated, tertiary neonatal medical center. PATIENTS: Twenty VLBW infants without severe neurologic problems or physical anomalies. On the day of the study, postnatal days were 17 to 82 days (49+/-18.91). OUTCOME MEASURES: Desaturation events. INTERVENTION: These infants were observed during oral feedings, once with a nasogastric tube and once without, at 9 am and 3 pm feedings within 1 day, decided in random order. RESULTS:Fifteen infants experienced 166 desaturation events (<90%), 83 desaturation events without the nasogastric tube, and 83 events with the nasogastric tube present. Infants for whom desaturation events developed has a longer transition period from tube feedings to oral feedings (p<0.05), and started feedings with lower oxygen saturation (p<0.05). Nearly all desaturation events (97%) occurred with breathing pauses (11.32+/-6.67 seconds), a change in heart rate, and an increase in end-tidal CO2. The presence of a nasogastric tube increased the duration of desaturation by an average of 8 seconds (p<0.05). CONCLUSION: Infants' oxygen saturation needs to be monitored with feedings, and feedings may need to be started with a baseline lowest saturation of 95% or higher, monitored with breathing and heart rate to prevent desaturation.
RCT Entities:
OBJECTIVE: To examine the desaturation events with the presence and absence of a nasogastric tube during an entire oral feeding in 20 very low birth weight (VLBW) infants. DESIGN: Prospective, quasi-experimental, random assignment. SETTING: Midwestern, university-affiliated, tertiary neonatal medical center. PATIENTS: Twenty VLBW infants without severe neurologic problems or physical anomalies. On the day of the study, postnatal days were 17 to 82 days (49+/-18.91). OUTCOME MEASURES: Desaturation events. INTERVENTION: These infants were observed during oral feedings, once with a nasogastric tube and once without, at 9 am and 3 pm feedings within 1 day, decided in random order. RESULTS: Fifteen infants experienced 166 desaturation events (<90%), 83 desaturation events without the nasogastric tube, and 83 events with the nasogastric tube present. Infants for whom desaturation events developed has a longer transition period from tube feedings to oral feedings (p<0.05), and started feedings with lower oxygen saturation (p<0.05). Nearly all desaturation events (97%) occurred with breathing pauses (11.32+/-6.67 seconds), a change in heart rate, and an increase in end-tidal CO2. The presence of a nasogastric tube increased the duration of desaturation by an average of 8 seconds (p<0.05). CONCLUSION:Infants' oxygen saturation needs to be monitored with feedings, and feedings may need to be started with a baseline lowest saturation of 95% or higher, monitored with breathing and heart rate to prevent desaturation.
Authors: Jang Hoon Lee; Yun Sil Chang; Hye Soo Yoo; So Yoon Ahn; Hyun Joo Seo; Seo Hui Choi; Ga Won Jeon; Soo Hyun Koo; Jong Hee Hwang; Won Soon Park Journal: World J Pediatr Date: 2011-10-20 Impact factor: 2.764