Factors Associated with Delayed Transition to Oral Feeding in Infants with Single Ventricle Physiology.
Factors Associated with Delayed Transition to Oral Feeding in Infants with Single Ventricle Physiology.
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与单心室生理婴儿延迟过渡到口服喂养相关的因素。
DOI：
10.1016/j.jpeds.2019.02.030
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Zyblewski,SinaiC
中科院分区：
文献类型：
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作者：
Kurtz,JoshuaD;Chowdhury,ShahryarM;Woodard,FrancisK;Strelow,JacobR;Zyblewski,SinaiC
ObjectivesTo描述时间的持续时间，以实现独家口服喂养的婴儿与单心室生理，并确定危险因素与长期胃造口管dependency.Study设计单中心，回顾性研究的婴儿与单心室生理。主要结局是达到经口喂养所需的持续时间。过渡期被定义为独家口服喂养格伦姑息（早期），1岁（中期），或1岁后（晚期）。结果78名婴儿进行了分析，46（59%）出院回家后，首次住院胃造口管。总体而言，39名婴儿（50%）实现了早期过渡，14名（18%）中期过渡，18名（23%）晚期过渡。早期过渡组术前经口进食比例较高（P<0.01），出院时年龄别体重z评分较高（P= 0.03），重症监护室时间较短（P<0.01），住院时间较短（P<0.01），入院时年龄别体重z评分较高（P= 0.02）。术前无经口进食（OR = 0.12，P = 0.02）和首次出院时大量心脏药物（OR = 3.8，P = 0.03）与未能实现早期过渡相关。术前无经口喂养（OR = 0.09，P = 0.01）和较长的重症监护室初始时间（OR = 1.1，P = 0.03）与未能实现中期过渡有关。结论术前经口喂养可能是一个潜在的可修改因素，有助于改善早期过渡到经口喂养。
ObjectivesTo describe the duration of time to achieve exclusive oral feeding in infants with single ventricle physiology and to identify risk factors associated with prolonged gastrostomy tube dependence.Study designSingle center, retrospective study of infants with single ventricle physiology. The primary outcome was duration of time required to achieve oral feeding. Transition periods were defined as exclusive oral feeding by Glenn palliation (early), by 1 year of age (mid), or after 1 year of age (late).ResultsSeventy-eight infants were analyzed; 46 (59%) were discharged to home with a gastrostomy tube after the initial hospitalization. Overall, 39 infants (50%) achieved early transition, 14 (18%) mid, and 18 (23%) late. The group who achieved early transition had a higher percentage of preoperative oral feeding (P< .01), greater weight-for-age z score at initial discharge (P= .03), shorter initial intensive care unit duration (P< .01), shorter initial hospital length of stay (P< .01), and greater weight-for-age z score at Glenn admission (P= .02). No preoperative oral feeding (OR = 0.12,P= .02) and greater number of cardiac medications at initial discharge (OR = 3.8,P= .03) were associated with failure to achieve early transition. No preoperative oral feeding (OR = 0.09,P= .01) and longer initial intensive care unit duration (OR = 1.1,P= .03) were associated with failure to achieve mid transition.ConclusionPreoperative oral feeding may potentially be a modifiable factor to help improve early transition to oral feeding.