Postoperative Feeding Guidelines Improve Outcomes in Surgical Infants

Shakeel, Fauzia; Newkirk, Melanie; Sellers, Austin; Shores, Darla R.

doi:10.1002/jpen.1726

Cited by 20 publications

(14 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To the best of our knowledge there are few (if any) studies addressing the strategy of initiating ‘ oral or gavage feeding ’ fast track concepts in newborns with congenital duodenal disorders as to what may be best considered the ‘ideal method ‘of advancing postoperative feeding [ 7 ]. We show that the monitoring of gastric content was of itself less crucial for accelerating feeding [ 1 ] thus encouraging the working practice paradigm of ‘scaling up feeds’.…”

Section: Discussionmentioning

confidence: 99%

“…There may however be theoretical concerns whether perinatal or perioperative stressors could be risk factors for NEC. Rapid feeding or ‘fast track’ regimens could however return the neonate to a more physiologic homeostatic process [ 5 ] reducing risks of intestinal failure associated liver disease (IFALD) from prolonged parenteral alimentation [ 6 , 7 ], with a shortened hospital stay (LOS) and better long-term outcome. In the surgical practice of routine monitoring of newborn gastric residual volumes, some studies have suggested it does not have any clear advantage in accelerating feeding and / or monitoring or the early detection of NEC [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Postoperative feeding in neonatal duodenal obstruction

2022

View full text Add to dashboard Cite

Background Findings from manometry studies and contrast imaging reveal functioning gastric physiology in newborns with duodenal atresia and stenosis. Stomach reservoir function should therefore be valuable in aiding the postoperative phase of gastric feeding. The aim of this study was therefore to compare the feasibility of initiating oral or large volume(s) gavage feeds vs small volume bolus feeds following operation for congenital duodenal anomalies. Methods Single-center electronic medical records of all babies with duodenal atresia and stenosis admitted to a university surgical center during January 1997–September 2021 were analyzed. A fast-fed group (FF) included newborns fed with oral or gavage feeds advanced at a rate of at least 2.5 ml/kg and then progressed more than once a day vs slow-fed group (SF) fed with gavage feeds at incremental rate less than 2.5 ml/kg/day for each time period of oral tolerance or by drip feeds. Total feed volume was limited to 120–150 ml/kg/day in the respective study cohort populations. Results Fifty-one eligible patients were recruited in the study - twenty-six in FF group and twenty-five in SF group. Statistically significant differences were observed in the (i) date of first oral feeds (POD 7.7 ± 3.2 vs 16.1 ± 7.7: p < 0.001), and (ii) first full feeds (POD 12.5 ± 5.3 vs 18.8 ± 9.7: p < 0.01) in FF vs SF study groups. Conclusion Initial feeding schedules with oral or incremental gavage-fed rates of at least 2.5 ml/kg in stepwise increments and multi-steps per day is wholly feasible in the postoperative feeding regimens of neonates with congenital duodenal disorders. Significant health benefits are thus achievable in these infants allowing an earlier time to acquiring full enteral feeding and their hospital discharge.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Postoperative feeding in neonatal duodenal obstruction

2022

View full text Add to dashboard Cite

show abstract

“…In neonatal population, the rates are increased, particularly in patients with necrotizing enterocolitis (NEC). When PN is required for more than 60 days, IFALD occurs in more than 75% of cases ( 11 ). Although IFALD has a multifactorial origin, it is widely accepted that soy-based lipid emulsions (SO-LEs), used for parenteral nutrition, play a primary pathogenic role due to their high phytosterol content, high ω-6 to ω-3 long-chain polyunsaturated fatty acid ratio, and low levels of α - tocopherol ( 12 ).…”

Section: Prevalence Etiology and Risk Factorsmentioning

confidence: 99%

“…Their study showed that the implementation of guidelines focused on postoperative feeding has a favorable impact on many parameters such as the timing of onset of postoperative enteral feeding, the time to achieve enteral autonomy, the incidence rates of IFALD, the peak of direct bilirubin, the overall use of PN, and the length of hospitalization. Furthermore, faster feeding advancement is associated with significantly decreased IFALD severity, lower peak of direct bilirubin, and higher percentage of IFALD resolution by discharge ( 11 ). Breast milk and amino acid-based formula seem to be the best options to re-feed infants with IF.…”

Section: Prevention and Treatmentmentioning

confidence: 99%

IFALD in children: What's new? A narrative review

2022

View full text Add to dashboard Cite

Intestinal failure-associated liver disease (IFALD) is a progressive liver disease complicating intestinal failure (IF). It is a preventable and reversible condition, but at the same time, a potential cause of liver cirrhosis and an indication to combined or non-combined liver and small bowel transplantation. The diagnostic criteria are not yet standardized, so that its prevalence varies widely in the literature. Pathophysiology seems to be multifactorial, related to different aspects of intestinal failure and not only to the long-term parenteral nutrition treatment. The survival rates of children with IF have increased, so that the main problems today are preventing complications and ensuring a good quality of life. IFALD is one of the most important factors that limit long-term survival of patients with IF. For this reason, more and more interest is developing around it and the number of published articles is increasing rapidly. The purpose of this narrative review was to focus on the main aspects of the etiology, pathophysiology, management, prevention, and treatment of IFALD, based on what has been published mainly in the last 10 years. Controversies and current research gaps will be highlighted with the aim to pave the way for new project and high-quality clinical trials.

show abstract

“…There may however be theoretical concerns whether perinatal or perioperative stressors could be risk factors for NEC. Rapid feeding or 'fast track' regimens could however return the neonate to a more physiologic homeostatic process [5] reducing risks of intestinal failure associated liver disease (IFALD) from prolonged parenteral alimentation [6,7], with a shortened hospital stay (LOS) and better long-term outcome. In the surgical practice of routine monitoring of newborn gastric residual volumes some studies have suggested it does not have any clear advantage in accelerating feeding and / or monitoring or the early detection of NEC [1].…”

Section: Introductionmentioning

confidence: 99%

Postoperative Feeding In Neonatal Duodenal Obstruction

Aroonsaeng

Losty

Thanachatchairattana

2022

Preprint

View full text Add to dashboard Cite

Background Findings from manometry studies and contrast imaging reveal functioning gastric physiology in newborns with duodenal atresia and stenosis. Stomach reservoir function should therefore be valuable in aiding the postoperative phase of gastric feeding. The aim of this study was therefore to compare the feasibility of initiating oral or large volume(s) gavage feeds vs small volume bolus feeds following the operation for congenital duodenal anomalies. Methods Single-center electronic medical records of all babies with duodenal atresia and stenosis admitted to a university surgical center during January 1997 - September 2021 were analyzed. A fast-fed group (FF) included newborns fed with oral or gavage feeds advanced at a rate of at least 2.5 ml/kg and then progressed more than once a day vs slow-fed group (SF) fed with gavage feeds at incremental rate less than 2.5 ml/kg/day for each time period of oral tolerance or by drip feeds. Total feed volume was limited to 120–150 ml/kg/day in the respective study cohort populations. Results 51 eligible patients were recruited in the study - twenty-six in FF group and twenty-five in SF group. Statistically significant differences were observed in the ( i ) date of first oral feeds (POD 7.7 ± 3.2 vs 16.1 ± 7.7: p < 0.001) and ( ii ) first full feeds (POD 12.5 ± 5.3 vs 18.8 ± 9.7: p < 0.01) in FF vs SF study groups. Conclusion Initial feeding schedules with oral or incremental gavage-fed rates of at least 2.5 ml/kg in stepwise increments and multi-steps per day is wholly feasible in the postoperative feeding regimens of neonates with congenital duodenal disorders. Significant health benefits are thus achievable in these infants allowing an earlier time to acquiring full enteral feeding and their hospital discharge.

show abstract

Postoperative Feeding Guidelines Improve Outcomes in Surgical Infants

Cited by 20 publications

References 39 publications

Postoperative feeding in neonatal duodenal obstruction

Postoperative feeding in neonatal duodenal obstruction

IFALD in children: What's new? A narrative review

Postoperative Feeding In Neonatal Duodenal Obstruction

Contact Info

Product

Resources

About