Gastrostomy tube placement in infants with congenital diaphragmatic hernia: Frequency, predictors, and growth outcomes.

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Rudra, S; Adibe, OO; Malcolm, WF; Smith, PB; Cotten, CM; Greenberg, RG

Published Date

  • December 2016

Published In

Volume / Issue

  • 103 /

Start / End Page

  • 97 - 100

PubMed ID

  • 27559682

Pubmed Central ID

  • 27559682

Electronic International Standard Serial Number (EISSN)

  • 1872-6232

Digital Object Identifier (DOI)

  • 10.1016/j.earlhumdev.2016.08.003

Language

  • eng

Conference Location

  • Ireland