title: Respiratory outcomes of children with BPD and gastrostomy tubes during the first 2 years of life.
abstract: OBJECTIVE
  Infants with bronchopulmonary dysplasia (BPD) often undergo gastrostomy tube (GT) placement and/or Nissen fundoplication (Nissen) to improve weight gain and to attenuate chronic respiratory symptoms related to feeding difficulties. After initial hospitalization little is known how these children do with regard to respiratory symptoms when compared to children with BPD who did not receive GTs. This study was done to determine if differences in respiratory outcomes were associated with the presence of a GT or Nissen/GT in children with BPD during the first 2 years of life.
  
  
  METHODS
  Children (n = 398) were recruited from the Johns Hopkins BPD Outpatient Clinic. Medical charts were reviewed and acute care usage and respiratory symptoms were assessed by caregiver questionnaires.
  
  
  RESULTS
  Ninety-two children with BPD had GTs, with the majority placed by 6 months of age. Of children with GTs, 64.7% also had Nissen fundoplication. Children with Nissen/GTs were more likely to have birth weights <10th percentile and to be discharged on supplemental oxygen. After initial hospitalization, children with GTs and Nissen/GTs weaned off supplemental oxygen at significantly older ages than children without GTs. Children with Nissen/GTs also had more hospitalizations than children without GTs. Caregivers of children with GTs and Nissen/GTs reported similar respiratory symptoms as caregivers of children without GTs.
  
  
  CONCLUSIONS
  Weaning off supplemental oxygen occurred later in children with GTs and Nissen/GTs compared to children without GTs. Although children with Nissen/GTs had more re-hospitalizations, there were no differences in reported respiratory symptoms between any of the groups by caregiver questionnaire.
authors.affiliation: Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Sharon A
authors.initials: SA
authors.lastname: McGrath-Morrow
authors.forename: Madoka
authors.initials: M
authors.lastname: Hayashi
authors.forename: Angela D
authors.initials: AD
authors.lastname: Aherrera
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Collaco
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000503:physiopathology / Q000601:surgery*; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D005260:Female; D018662:Fundoplication; D005774:Gastrostomy / Q000295:instrumentation*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D012140:Respiratory Tract Diseases / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D014481:United States
keywords: Nissen fundoplication; bronchopulmonary dysplasia; gastrostomy tube; prematurity; respiratory outcomes
references.citation: Early Hum Dev. 2003 Dec;75(1-2):71-8
references.pmid: 14652160
references.citation: Pediatrics. 2007 Oct;120(4):e1035-42
references.pmid: 17893188
references.citation: Dev Med Child Neurol. 2006 Jul;48(7):595-9
references.pmid: 16780630
references.citation: BMC Pediatr. 2003 Jul 8;3:6
references.pmid: 12848901
references.citation: J Pediatr Surg. 2010 Feb;45(2):346-9
references.pmid: 20152349
references.citation: Chest. 1997 Dec;112(6):1607-14
references.pmid: 9404761
references.citation: Semin Perinatol. 2006 Aug;30(4):200-8
references.pmid: 16860160
references.citation: Pediatrics. 2006 Apr;117(4):1253-61
references.pmid: 16585322
references.citation: Pediatrics. 2005 Dec;116(6):1353-60
references.pmid: 16322158
references.citation: World J Pediatr. 2011 Nov;7(4):337-43
references.pmid: 22015726
references.citation: Anesth Analg. 1998 Jul;87(1):127-33
references.pmid: 9661561
references.citation: Pediatr Pulmonol. 2010 Feb;45(2):165-73
references.pmid: 20054861
references.citation: Curr Opin Pediatr. 2011 Apr;23(2):167-72
references.pmid: 21169836
references.citation: J Perinatol. 2012 Jan;32(1):33-8
references.pmid: 21546943
references.citation: Am Rev Respir Dis. 1988 Sep;138(3):725-9
references.pmid: 3059876
references.citation: Crit Care. 2012 Dec 12;16(2):R35
references.pmid: 22380702
references.citation: Natl Vital Stat Rep. 2011 Nov 3;60(1):1-70
references.pmid: 22670489
references.citation: Anesth Analg. 2005 Jul;101(1):213-9, table of contents
references.pmid: 15976234
references.citation: Am J Speech Lang Pathol. 2010 Nov;19(4):321-40
references.pmid: 20622046