Antroduodenal motility and feeding outcome among neonatal extracorporeal membrane oxygenation survivors.
OBJECTIVE
Feeding difficulties are common among survivors of extracorporeal membrane oxygenation (ECMO). In this study, we characterized antroduodenal motor patterns and feeding outcomes among 10 ECMO survivors.


METHODS
Intestinal motor patterns were recorded in 10 ECMO survivors within 48 hours of the initiation of enteral feeding. Subsequent feeding outcomes were tracked until discharge. We compared the motor patterns of infants achieving full oral feedings by 1 month postnatal age with those who did not achieve full oral feedings by 1 month postnatal age.


RESULTS
In infants failing to achieve full oral feedings, duodenal clusters occupied less of the total record (P < 0.05), and clusters had significantly lower amplitude (P < 0.05) than were seen in successful infants. Infants failing to achieve full oral feedings had greater time spent in motor quiescence (P < 0.05) than successful infants. Neither group had migrating motor complexes during fasting or mature duodenal motor responses to feeding. At discharge, six infants with feeding failure were more likely to require tube feeding, and the hospital stay was 3.6 times longer. Intracranial abnormalities were detected by computed tomography scan in five of six infants with feeding failure.


CONCLUSIONS
Early intestinal dysmotility in infants surviving ECMO is associated with later feeding difficulties and prolonged hospitalization.
Jadcherla
Sudarshan R
SR
Division of Neonatology and Pediatric Gastroenterology and Nutrition, Columbus Children's Hospital and Children's Research Institute, Department of Pediatrics at the OSU, Columbus, Ohio 43205, USA. jadcherlas@pediatrics.ohio-state.edu
Berseth
Carol Lynn
CL
D000375:Aging / Q000502:physiology; D001921:Brain / Q000002:abnormalities / Q000000981:diagnostic imaging; D004386:Duodenum / Q000502:physiology; D004750:Enteral Nutrition; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007225:Infant Food; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000503:physiopathology* / Q000628:therapy; D007234:Infant, Premature / Q000502:physiology; D007902:Length of Stay; D008297:Male; D008365:Manometry; D011446:Prospective Studies; D011706:Pyloric Antrum / Q000502:physiology; D011859:Radiography