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Arch Dis Child Fetal Neonatal Ed. 2015 May;100(3):F224-8. doi: 10.1136/archdischild-2014-307067. Epub 2014 Dec 31.

A randomised trial of re-feeding gastric residuals in preterm infants.

Author information

1
Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
2
Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri, USA.
3
Department of Pediatrics, University of Maryland, Baltimore, Maryland, USA.
4
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
5
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Abstract

OBJECTIVE:

To determine whether re-feeding of gastric residual volumes reduces the time needed to achieve full enteral feeding in preterm infants.

DESIGN:

Parallel-group randomised controlled trial with a 1:1 allocation ratio.

SETTING:

Regional referral neonatal intensive care unit.

PATIENTS:

72 infants of gestational age 23(0/7) to 28(6/7) weeks receiving minimal enteral nutrition (<24 mL/kg/day) during the first week after birth.

INTERVENTIONS:

Infants were randomised to either be re-fed with gastric residual volumes (Re-feeding group) or receive fresh formula/human milk (Fresh-feeding group) whenever large gastric residual volumes were noted.

MAIN OUTCOME MEASURE:

The primary efficacy end point was time to achieve full enteral feeding (≥120 mL/kg/day) after randomisation.

RESULTS:

The mean time to full enteral feeding was 10.0 days in the Re-feeding group and 11.3 days in the Fresh-feeding group (mean difference favouring re-feeding: -1.3 days; 95% CI -2.9 to 0.3; p=0.11). The composite safety end point of spontaneous intestinal perforation, surgical necrotising enterocolitis, or death occurred in 6 of 36 infants (17%) in the Re-feeding group versus 10 of 36 infants (28%) in the Fresh-feeding group (p=0.26).

CONCLUSIONS:

Re-feeding gastric residual volumes in extremely preterm infants does not reduce time to achieve full enteral feeding. This trial suggests that re-feeding might be as safe as fresh feeding, but further research is needed, due to lack of sufficient statistical power in this study for safety analysis.

TRIAL REGISTRATION NUMBER:

NCT01420263NCT01420263.

KEYWORDS:

Infant Feeding; Neonatology

[Indexed for MEDLINE]

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