title: Predicting Full Enteral Feeding in the Postoperative Period in Infants with Congenital Diaphragmatic Hernia.
abstract: IntroductionThe objective of the study is to examine the factors associated with time to achieve full enteral feeding after repair of congenital diaphragmatic hernia.Materials and MethodsDemographic, clinical, and therapeutic data were retrospectively assessed, and uni- and multivariate Cox regression were performed to examine factors predictive of achieving full enteral feeding that was defined as time to achieve120 mL/kg/d after surgical repair.ResultsOf 78 infants, 66 underwent intervention before hospital discharge. All infants who survived had reached full enteral feeding at the time of hospital discharge by a median of 22 days (range: 2-119 days) after surgery and 10 days (range: 1-91) after initiation of postoperative enteral feedings. Independent risk factors associated with a longer time to reach full enteral feeding achievement included gastroesophageal reflux and days of antibiotics in the postoperative period. Daily stool passage preoperatively predicted earlier enteral tolerance.ConclusionInfants who survive congenital diaphragmatic hernia generally are able to achieve full enteral feedings after surgical repair. A longer time to full feeding is needed in the most severe cases, but some specific characteristics can be used to help identify patients at higher risk. Although some of these characteristics are unavoidable, others including rational antibiotic usage and active gastroesophageal reflux prevention and treatment are feasible and may improve enteral tolerance.
authors.affiliation: Department of Neonatology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Zozaya
authors.affiliation: Department of Neonatology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Miryam
authors.initials: M
authors.lastname: Triana
authors.affiliation: Department of Biostatistics Unit, Hospital Universitario La Paz, Madrid, Spain.|Instituto de Salud Carlos III, Red de Salud Materno Infantil y Desarrollo-SAMID, Madrid, Spain.
authors.forename: Rosario
authors.initials: R
authors.lastname: Madero
authors.affiliation: Department of Pediatrics, Dell Medical School, The University of Texas, Austin, Texas, United States.
authors.forename: Steven
authors.initials: S
authors.lastname: Abrams
authors.affiliation: Instituto de Salud Carlos III, Red de Salud Materno Infantil y Desarrollo-SAMID, Madrid, Spain.|Department of Pediatric Surgery, Hospiltal Infantil La Paz, Madrid, Spain.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Martinez
authors.affiliation: Department of Pediatric Surgery, Hospiltal Infantil La Paz, Madrid, Spain.
authors.forename: Maria Virginia
authors.initials: MV
authors.lastname: Amesty
authors.affiliation: Department of Neonatology, Hospital Universitario La Paz, Madrid, Spain.|Instituto de Salud Carlos III, Red de Salud Materno Infantil y Desarrollo-SAMID, Madrid, Spain.
authors.forename: Miguel Sáenz de
authors.initials: MS
authors.lastname: Pipaón
mesh_terms: D004750:Enteral Nutrition / Q000706:statistics & numerical data*; D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D010288:Parenteral Nutrition / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000706:statistics & numerical data*; D011184:Postoperative Period; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome