Nasogastric compared with nasoduodenal feeding in low birthweight infants.

Systematic review of transpyloric versus gastric tube feeding for preterm infants

“…This may be of particular importance with regard to the largest of the included studies. 21 In this study, the infants who were allocated to transpyloric feeding were of significantly lower gestational age (mean 27.7 weeks v 28.5 weeks in the gastric feeding group), and had significantly lower Apgar scores at one minute (mean 3.6 v 6.2) and five minutes (mean 6.3 v 8.3). It is possible that, because of allocation bias, some of the less mature and sicker infants may have been allocated preferentially to transpyloric feeding.…”

“…In the largest included trial, only 41 of the 80 infants who entered the study were included in the growth data analysis. 21 In another trial, there were outcome data for only 44 of the 66 infants allocated to a feeding route. 20 It may be that repeated failed attempts to position the transpyloric tube introduced a delay in starting or establishing nutritional input.…”

“…21 In a meta-analysis, there was a significantly higher rate of death in the infants who were fed by the transpyloric route: RR: 2.5 (95% CI 1.4 to 4.5); RD: 0.16 (95% CI 0.07 to 0.26). When the study with possible allocation bias was excluded, the increase in mortality in the transpyloric group was not quite significant: RR: 2.2 (95% CI 0.9 to 5.4); RD: 0.1 (95% CI 0.00 to 0.2).…”

“…[7][8][9][10][11][12][13][14][15][16][17][18][19] We included eight studies, enrolling a total of 340 infants. [20][21][22][23][24][25][26][27] One of the studies 24 was reported previously in abstract form only. 28 Table 2 shows the main characteristics, and table 3 shows the quality assessment of these trials.…”

“…[20][21][22][23][24] There were no significant differences in the growth variables in any of the trials. We undertook meta-analyses where sufficient data (mean and standard deviation) were available, and these did not show any significant differences.…”