Enteral feeding during indomethacin treatment for patent ductus arteriosus: association with gastrointestinal outcomes

Enteral feeds are often discontinued or reduced during indomethacin treatment for patent ductus arteriosus (PDA) in preterm neonates, but the clinical impact of this practice is unknown. The objective of this study was to study the associations between enteral feed volume at the time of indomethacin...

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Bibliographic Details
Published in:Journal of perinatology 2016-07, Vol.36 (7), p.544-548
Main Authors: Louis, D, Torgalkar, R, Shah, J, Shah, P S, Jain, A
Format: Article
Language:English
Subjects:
Birth Weight
Breastfeeding & lactation
Canada
Care and treatment
Cohort analysis
Complications
Complications and side effects
Congenital diseases
Coronary vessels
Digestive symptoms
Dosage and administration
Drug dosages
Ductus Arteriosus, Patent - complications
Ductus Arteriosus, Patent - therapy
Enteral feeding
Enteral Nutrition
Enterocolitis
Enterocolitis, Necrotizing - chemically induced
Enterocolitis, Necrotizing - epidemiology
Epidemiology
Female
Gastrointestinal diseases
Gestational Age
Health aspects
Humans
Indomethacin
Indomethacin - administration & dosage
Indomethacin - adverse effects
Infant, Extremely Premature - growth & development
Infant, Newborn
Infant, Very Low Birth Weight - growth & development
Intensive care
Intensive care units
Intensive Care Units, Neonatal
Linear Models
Logistic Models
Male
Methods
Morbidity
Multivariate Analysis
Necrotizing enterocolitis
Neonates
Patent ductus arteriosus
Pediatrics
Physiological aspects
Preempting
Premature infants
Reduction
Retrospective Studies
Risk factors
Secondary analysis
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Summary:Enteral feeds are often discontinued or reduced during indomethacin treatment for patent ductus arteriosus (PDA) in preterm neonates, but the clinical impact of this practice is unknown. The objective of this study was to study the associations between enteral feed volume at the time of indomethacin therapy in preterm neonates with PDA and subsequent gastrointestinal outcomes. Retrospective cohort study. Single-center level III Neonatal Intensive Care Unit. All consecutive preterm neonates who had received treatment with indomethacin for PDA over a 5-year period were included and categorized based on enteral feed volume exposure during treatment (Group A: nil per oral (NPO, N=229); Group B: ⩽60 ml kg(-1) day(-1) (N=142); Group C:>60 ml kg(-1) day(-1) (N=44)). Baseline characteristics and clinical outcomes were compared between the three groups. The primary outcome was necrotizing enterocolitis (NEC) ⩾stage IIa, while secondary outcomes included other gastrointestinal complications and common prematurity-related morbidities. Group C had a higher gestational age (mean±s.d.; A: 26.3±1.8; B: 26.1±1.8; C: 27.0±2.0 weeks), birth weight (A: 864±239; B: 847±202; C: 932±234 g) and postnatal age at the time of indomethacin treatment (A: 5.3±2.9; B: 7.2±4.9; C: 15.4±6.6 days). All groups had similar rates of the primary outcome NEC (A: 6.1%, B: 7.8% and C: 4.6%, respectively). They also had similar rates of the secondary outcomes with the exception of days to reach enteral feeds of 120 ml kg(-1) day(-1) (A: 22.8±8.5; B: 20.5±8.6; C: 16.8±7.7; P
ISSN:0743-8346
1476-5543
DOI:10.1038/jp.2016.11