Desaturation events during oral feedings with and without a nasogastric tube in very low birth weight infants.
OBJECTIVE
To examine the desaturation events with the presence and absence of a nasogastric tube during an entire oral feeding in 20 very low birth weight (VLBW) infants.


METHODS
Prospective, quasi-experimental, random assignment.


METHODS
Midwestern, university-affiliated, tertiary neonatal medical center.


METHODS
Twenty VLBW infants without severe neurologic problems or physical anomalies. On the day of the study, postnatal days were 17 to 82 days (49+/-18.91).


METHODS
Desaturation events.


METHODS
These infants were observed during oral feedings, once with a nasogastric tube and once without, at 9 am and 3 pm feedings within 1 day, decided in random order.


RESULTS
Fifteen infants experienced 166 desaturation events (<90%), 83 desaturation events without the nasogastric tube, and 83 events with the nasogastric tube present. Infants for whom desaturation events developed has a longer transition period from tube feedings to oral feedings (p<0.05), and started feedings with lower oxygen saturation (p<0.05). Nearly all desaturation events (97%) occurred with breathing pauses (11.32+/-6.67 seconds), a change in heart rate, and an increase in end-tidal CO2. The presence of a nasogastric tube increased the duration of desaturation by an average of 8 seconds (p<0.05).


CONCLUSIONS
Infants' oxygen saturation needs to be monitored with feedings, and feedings may need to be started with a baseline lowest saturation of 95% or higher, monitored with breathing and heart rate to prevent desaturation.
Shiao
S Y
SY
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106-4904, USA.
Brooker
J
J
DiFiore
T
T
D004435:Eating / Q000502:physiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood* / Q000502:physiology; D007441:Intubation, Gastrointestinal / Q000009:adverse effects; D008297:Male; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D013391:Sucking Behavior
D010100:Oxygen