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著者: Bettina Bohnhorst, Kathrin Cech, Corinna Peter, Michael Doerdelmann
雑誌名: Neonatology. 2010;98(2):143-9. doi: 10.1159/000279617. Epub 2010 Mar 16.
Abstract/Text
BACKGROUND: Raised upper airway resistance may be involved in apnea of prematurity (AOP).
OBJECTIVES: To determine the effects of an oral versus a nasal gastric tube on episodes of hypoxemia and bradycardia in infants with AOP.
METHODS: In a randomized controlled cross-over trial, 32 infants (median gestational age 29 (range 24-31) weeks, postmenstrual age at study 32 (range 30-35) weeks) with the need for tube feeding and symptoms of AOP underwent a 24-hour recording of breathing movements, nasal airflow, heart rate, pulse oximeter saturation and pulse waveforms. A 5-Fr feeding tube was placed orally or nasally for 12 h each, the position selected first was randomly assigned. When the feeding tube was placed nasally, always the smaller nostril was selected. Each infant acted as his/her own control. Recordings were analyzed for the summed rate of bradycardia and desaturation (heart rate <2/3 of baseline, saturation RESULTS: The route of placing the feeding tube had no significant effect on the summed rate of bradycardia and desaturation (nasal route: median 1.6, CI 0.8-1.9; oral route: median 1.0, CI 0.9-1.6, p = 0.25).
CONCLUSION: We could not confirm an advantage of placing a feeding tube orally in these infants with AOP, as the oral route did not improve their symptoms of AOP. Possible explanations include: (i) the increase in nasal airway resistance by the 5-Fr nasogastric tube, inserted into the smaller nostril, is too small to have any effect on AOP; (ii) any benefit of the oral route is neutralized by the negative effects of an enhanced vagal stimulation, or (iii) study duration was too short to detect a difference in AOP.
Copyright 2010 S. Karger AG, Basel.
PMID 20234138 Neonatology. 2010;98(2):143-9. doi: 10.1159/000279617. Epub 2010 Mar 16.
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