Actual and Potential Impact of a Home Nasogastric Tube Feeding Program for Infants Whose Neonatal Intensive Care Unit Discharge Is Affected by Delayed Oral Feedings.
Actual and Potential Impact of a Home Nasogastric Tube Feeding Program for Infants Whose Neonatal Intensive Care Unit Discharge Is Affected by Delayed Oral Feedings.
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DOI：
10.1016/j.jpeds.2021.03.046
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Brousseau DC
中科院分区：
文献类型：
--
作者：
Lagatta JM;Uhing M;Acharya K;Lavoie J;Rholl E;Malin K;Malnory M;Leuthner J;Brousseau DC
比较三组因口服喂养延迟新生儿重症监护病房（NICU）出院的婴儿的医疗保健利用和父母健康相关生活质量（HRQL）。2018年9月至2020年3月NICU新生儿前瞻性单中心队列研究。登记后，每周的图表审查确定资格的家庭鼻胃（NG）饲料基于预定的标准。实际出院喂养决定由临床酌情决定。在出院后3个月，我们比较了急性医疗保健利用和父母健康相关生活质量（HRQL），由PedsQL家庭影响模块测量，在符合NG条件的婴儿中，他们出院时使用口服喂养，出院时使用NG喂养，出院时使用G管。我们计算了家庭NG出院所节省的新生儿重症监护病房天数。180例患儿中，口服喂养80例，NG 35例，G管65例。与ng喂养的婴儿相比，g管喂养的婴儿有更多的胃肠道或与管道相关的再入院和急诊（未经调整的or为3.97,95%CI为1.3-12.7,p=0.02），而口服喂养的婴儿在使用方面没有差异（未经调整的or为0.41,95%CI为0.1-1.7,p=0.225）。多变量调整并没有改变这些比较。3个月时父母HRQL组间无差异。新生儿出院后可节省新生儿重症监护病房1574天。新生儿重症监护病房出院时使用NG喂养与新生儿重症监护病房住院时间缩短相关，但未增加出院后医疗保健利用率或降低家长HRQL，而G管喂养与出院后医疗保健利用率增加相关。
To compare healthcare utilization and parent health-related quality of life (HRQL) in three groups of infants whose neonatal intensive care unit (NICU) discharge was delayed by oral feedings. prospective single-center cohort of infants in the NICU from September 2018-March 2020. After enrollment, weekly chart review determined eligibility for home nasogastric (NG) feeds based on predetermined criteria. Actual discharge feeding decisions were at clinical discretion. At 3 months post-discharge, we compared acute healthcare utilization and parental health-related quality of life (HRQL), measured by the PedsQL Family Impact Module, among infants who were NG eligible but discharged with all oral feeds, discharged with NG feeds, and discharged with G tubes. We calculated NICU days saved by home NG discharges. Among 180 infants, 80 were orally fed, 35 used NG and 65 used G tubes. Compared with NG-fed infants, G-tube-fed infants had more GI or tube-related readmissions and emergency encounters (unadjusted OR 3.97, 95%CI 1.3-12.7, p=0.02), and orally-fed infants showed no difference in utilization (unadjusted OR 0.41, 95%CI 0.1-1.7, p=0.225). Multivariable adjustment did not change these comparisons. Parent HRQL at 3 months did not differ between groups. Infants discharged home with NG tubes saved 1574 NICU days. NICU discharge with NG feeds is associated with reduced NICU stay without increased post-discharge healthcare utilization or decreased parent HRQL, whereas G tube feeding was associated with increased post-discharge healthcare utilization.
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影响因子：
2.4
作者：
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通讯作者：
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