Background NICU patients are commonly discharged home with nasogastric (NG) or gastrostomy (G-tube) feeding, but wide practice variation exists. The objective of this study was to evaluate feeding and growth outcomes and complications in NICU patients discharged home with NG or G-tube feeding. Study design Retrospective cohort study of infants discharged from a Level IV NICU with an NG or G-tube who had follow up to 1 year. Clinical characteristics and outcomes were compared between groups.
ResultsThe study sample included 264 infants: 140 with NG and 124 with G-tube. More infants in the G-tube group (65%) still required tube feedings 12 months post-discharge than infants in the NG group (24%). Infants in the G-tube group had more tube-related ER visits than infants in the NG group. Growth outcomes did not differ. Conclusion Home NG feeding may be a safe alternative to a surgically placed G-tube in select NICU patients.
We report MRI and proton MR spectroscopy (MRS) findings in a 12-month-old girl with Epstein-Barr virus encephalitis. CT and MRI showed focal lesions in the basal ganglia. MRS of the lesions showed decreased N-acetyl aspartate and elevation of some amino acids, indicating an infectious rather than ischemic etiology. This case illustrates the use of MRS to narrow differential diagnosis.
<b><i>Objective:</i></b><i></i>The aim of this study was to determine the relationship of superior mesenteric artery (SMA) blood flow and intestinal motility with feeding tolerance in infants with gastroschisis. <b><i>Study Design:</i></b> This was a prospective observational cohort study of 23 infants with gastroschisis. Magnetic resonance images were obtained at abdominal wall closure, initiation of feeds, and full feeds. Motility and SMA flow data were correlated with feeding tolerance. <b><i>Result:</i></b><i></i>All infants had abnormal motility, and most continued with abnormal motility despite achieving full feeds. Increased SMA flow at the time of abdominal wall closure was found to be significantly related to the earlier achievement of full feeds (ρ = –0.45, <i>p</i> = 0.05) and trended towards earlier initiation of feeds (ρ = –0.36, <i>p</i> = 0.13), shorter parenteral nutrition days (ρ = –0.42, <i>p</i> = 0.07), and earlier discharge (ρ = –0.41, <i>p</i> = 0.08). <b><i>Conclusion:</i></b> Increased SMA blood flow at the time of abdominal wall closure is positively correlated with feeding tolerance, suggesting the importance of initial intestinal perfusion in the pathophysiology for feeding intolerance and intestinal dysmotility in gastroschisis.
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