Early Commencement of Enteral Feeds in Gastroschisis: A Systematic Review of Literature

Abstract

Introduction There are no evidence-based strategies to improve feed tolerance in gastroschisis. Early commencement of enteral feeds (CEF) is known to improve feed tolerance in preterm infants. It is possible that infants with gastroschisis may also benefit from early CEF.

Objective To conduct a systematic review to evaluate the relationship between time of CEF, and time to reach full enteral feeds (FEF), duration of parenteral nutrition (PN), and duration of hospital stay (HS).

Methods PubMed, EMBASE, Cochrane CENTRAL, and relevant conference abstracts were searched in December 2015. Studies of any design reporting on time to CEF and one or more of the outcomes of interest were included. Meta-regression analysis was conducted to find the association between time to CEF and the outcomes of interest.

Results There were no randomized controlled trials (RCTs) comparing early (≤7 days from birth) versus delayed (>7 days) CEF. Forty-two observational studies on gastroschisis (4,835 infants) where feed-related information was available were included. Meta-regression results indicated that each day delay in CEF was associated with a delay of an additional 1.4 days (95% confidence interval [CI]: 0.95, 1.85) to FEF, 2.05 days (95% CI: 1.50, 2.59) to the duration of PN, and 1.91 days (95% CI: 1.37, 2.45) to the duration of HS. Sensitivity analysis after excluding studies that provided information exclusively on complex gastroschisis continued to show beneficial effects of early CEF.

Conclusion Early CEF may be associated with early attainment of FEF in gastroschisis. RCTs comparing early versus delayed CEF are needed urgently.

Keywords

systematic review - feed intolerance - abdominal wall defect - parenteral nutrition

• References

• 1 Holland AJ, Walker K, Badawi N. Gastroschisis: an update. Pediatr Surg Int 2010; 26 (09) 871-878
• 2 Alvarez SM, Burd RS. Increasing prevalence of gastroschisis repairs in the United States: 1996-2003. J Pediatr Surg 2007; 42 (06) 943-946
• 3 Hougland KT, Hanna AM, Meyers R, Null D. Increasing prevalence of gastroschisis in Utah. J Pediatr Surg 2005; 40 (03) 535-540
• 4 Vo LUT, Langlois PH. Time trends in prevalence of gastroschisis in Texas, 1999 to 2011: subgroup analyses by maternal and infant characteristics. Birth Defects Res A Clin Mol Teratol 2015; 103 (11) 928-940
• 5 Balgi S, Singhal S, Mueller G, Batton B. Feeding intolerance and poor growth in infants with gastroschisis: longitudinal experience with consecutive patients over thirteen years. J Neonatal Surg 2015; 4 (04) 42
• 6 Bradnock TJ, Marven S, Owen A. , et al; BAPS-CASS. Gastroschisis: one year outcomes from national cohort study. BMJ 2011; 343: d6749
• 7 Youssef F, Cheong LH, Emil S. ; Canadian Pediatric Surgery Network (CAPSNet). Gastroschisis outcomes in North America: a comparison of Canada and the United States. J Pediatr Surg 2016; 51 (06) 891-895
• 8 Langer JC, Longaker MT, Crombleholme TM. , et al. Etiology of intestinal damage in gastroschisis. I: effects of amniotic fluid exposure and bowel constriction in a fetal lamb model. J Pediatr Surg 1989; 24 (10) 992-997
• 9 Krebs T, Boettcher M, Schäfer H. , et al. Gut inflammation and expression of ICC in a fetal lamb model of fetoscopic intervention for gastroschisis. Surg Endosc 2014; 28 (08) 2437-2442
• 10 Zani-Ruttenstock E, Zani A, Paul A, Diaz-Cano S, Ade-Ajayi N. Interstitial cells of Cajal are decreased in patients with gastroschisis associated intestinal dysmotility. J Pediatr Surg 2015; 50 (05) 750-754
• 11 Centers for Disease Control and Prevention (CDC). Hospital stays, hospital charges, and in-hospital deaths among infants with selected birth defects--United States, 2003. Morb Mortal Wkly Rep 2007; 56 (02) 25-29
• 12 Morgan J, Young L, McGuire W. Delayed introduction of progressive enteral feeds to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database Syst Rev 2014; (12) CD001970
• 13 Morgan J, Young L, McGuire W. Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database Syst Rev 2015; (10) CD001241
• 14 Higgins JPT, Green S. , eds. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available at: http://handbook.cochrane.org. Accessed April 10, 2016
• 15 Liberati A, Altman DG, Tetzlaff J. , et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 2009; 151 (04) W65–W94
• 16 Stroup DF, Berlin JA, Morton SC. , et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000; 283 (15) 2008-2012
• 17 Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 2014; 14 (01) 135
• 18 AlFaleh K, Anabrees J. Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev 2014; (04) CD005496
• 19 Allotey J, Davenport M, Njere I. , et al. Benefit of preformed silos in the management of gastroschisis. Pediatr Surg Int 2007; 23 (11) 1065-1069
• 20 Al-Kaff A, MacDonald SC, Kent N, Burrows J, Skarsgard ED, Hutcheon JA. ; Canadian Pediatric Surgery Network. Delivery planning for pregnancies with gastroschisis: findings from a prospective national registry. Am J Obstet Gynecol 2015; 213 (04) 557.e1-557.e8
• 21 Badillo AT, Hedrick HL, Wilson RD. , et al. Prenatal ultrasonographic gastrointestinal abnormalities in fetuses with gastroschisis do not correlate with postnatal outcomes. J Pediatr Surg 2008; 43 (04) 647-653
• 22 Banyard D, Ramones T, Phillips SE, Leys CM, Rauth T, Yang EY. Method to our madness: an 18-year retrospective analysis on gastroschisis closure. J Pediatr Surg 2010; 45 (03) 579-584
• 23 Bucher BT, Mazotas IG, Warner BW, Saito JM. Effect of time to surgical evaluation on the outcomes of infants with gastroschisis. J Pediatr Surg 2012; 47 (06) 1105-1110
• 24 Cauchi J, Parikh DH, Samuel M, Gornall P. Does gastroschisis reduction require general anesthesia? A comparative analysis. J Pediatr Surg 2006; 41 (07) 1294-1297
• 25 Charlesworth P, Njere I, Allotey J. , et al. Postnatal outcome in gastroschisis: effect of birth weight and gestational age. J Pediatr Surg 2007; 42 (05) 815-818
• 26 Choi WW, McBride CA, Bourke C. , et al. Long-term review of sutureless ward reduction in neonates with gastroschisis in the neonatal unit. J Pediatr Surg 2012; 47 (08) 1516-1520
• 27 Cohen-Overbeek TE, Hatzmann TR, Steegers EA, Hop WC, Wladimiroff JW, Tibboel D. The outcome of gastroschisis after a prenatal diagnosis or a diagnosis only at birth. Recommendations for prenatal surveillance. Eur J Obstet Gynecol Reprod Biol 2008; 139 (01) 21-27
• 28 Cowan KN, Puligandla PS, Laberge J-M. , et al; Canadian Pediatric Surgery Network. The gastroschisis prognostic score: reliable outcome prediction in gastroschisis. J Pediatr Surg 2012; 47 (06) 1111-1117
• 29 Curry JI, Lander AD, Stringer MD. ; BAPS Multicentre Research Committee. A multicenter, randomized, double-blind, placebo-controlled trial of the prokinetic agent erythromycin in the postoperative recovery of infants with gastroschisis. J Pediatr Surg 2004; 39 (04) 565-569
• 30 Davies MW, Kimble RM, Cartwright DW. Gastroschisis: ward reduction compared with traditional reduction under general anesthesia. J Pediatr Surg 2005; 40 (03) 523-527
• 31 Davis RP, Treadwell MC, Drongowski RA, Teitelbaum DH, Mychaliska GB. Risk stratification in gastroschisis: can prenatal evaluation or early postnatal factors predict outcome?. Pediatr Surg Int 2009; 25 (04) 319-325
• 32 Eggink BH, Richardson CJ, Malloy MH, Angel CA. Outcome of gastroschisis: a 20-year case review of infants with gastroschisis born in Galveston, Texas. J Pediatr Surg 2006; 41 (06) 1103-1108
• 33 Emami CN, Youssef F, Baird RJ, Laberge JM, Skarsgard ED, Puligandla PS. ; Canadian Pediatric Surgery Network (CAPSNet). A risk-stratified comparison of fascial versus flap closure techniques on the early outcomes of infants with gastroschisis. J Pediatr Surg 2015; 50 (01) 102-106
• 34 Emil S, Canvasser N, Chen T, Friedrich E, Su W. Contemporary 2-year outcomes of complex gastroschisis. J Pediatr Surg 2012; 47 (08) 1521-1528
• 35 Gupta V, Trivedi A, Walker K, , J A Holland A. Neurodevelopmental outcome of infants with gastroschisis at one-year follow-up. J Neonatal Surg 2015; 4 (02) 12
• 36 Harris J, Poirier J, Selip D. , et al. Early closure of gastroschisis after silo placement correlates with earlier enteral feeding. J Neonatal Surg 2015; 4 (03) 28
• 37 Hassan S, Pimpalwar A. Primary suture-less closure of gastroschisis using negative pressure dressing (wound vacuum). Eur J Pediatr Surg 2011; 21 (05) 287-291
• 38 Huang J, Kurkchubasche AG, Carr SR, Wesselhoeft Jr CW, Tracy Jr TF, Luks FL. Benefits of term delivery in infants with antenatally diagnosed gastroschisis. Obstet Gynecol 2002; 100 (04) 695-699
• 39 Jensen AR, Waldhausen JH, Kim SS. The use of a spring-loaded silo for gastroschisis: impact on practice patterns and outcomes. Arch Surg 2009; 144 (06) 516-519
• 40 Kohler Sr JA, Perkins AM, Bass WT. Human milk versus formula after gastroschisis repair: effects on time to full feeds and time to discharge. J Perinatol 2013; 33 (08) 627-630
• 41 Lemoine JB, Smith RR, White D. Got milk? Effects of early enteral feedings in patients with gastroschisis. Adv Neonatal Care 2015; 15 (03) 166-175
• 42 Lobo JD, Kim AC, Davis RP. , et al. No free ride? The hidden costs of delayed operative management using a spring-loaded silo for gastroschisis. J Pediatr Surg 2010; 45 (07) 1426-1432
• 43 Maksoud-Filho JG, Tannuri U, da Silva MM, Maksoud JG. The outcome of newborns with abdominal wall defects according to the method of abdominal closure: the experience of a single center. Pediatr Surg Int 2006; 22 (06) 503-507
• 44 McNamara WF, Hartin CW, Escobar MA, Lee Y-H. Outcome differences between gastroschisis repair methods. J Surg Res 2011; 165 (01) 19-24
• 45 Minutillo C, Rao SC, Pirie S, McMichael J, Dickinson JE. Growth and developmental outcomes of infants with gastroschisis at one year of age: a retrospective study. J Pediatr Surg 2013; 48 (08) 1688-1696
• 46 Murthy K, Evans JR, Bhatia AM. , et al. The association of type of surgical closure on length of stay among infants with gastroschisis born≥34 weeks' gestation. J Pediatr Surg 2014; 49 (08) 1220-1225
• 47 Orion KC, Krein M, Liao J, Shaaban AF, Pitcher GJ, Shilyansky J. Outcomes of plastic closure in gastroschisis. Surgery 2011; 150 (02) 177-185
• 48 Overcash RT, DeUgarte DA, Stephenson ML. , et al; University of California Fetal Consortium. Factors associated with gastroschisis outcomes. Obstet Gynecol 2014; 124 (03) 551-557
• 49 Owen A, Marven S, Jackson L. , et al. Experience of bedside preformed silo staged reduction and closure for gastroschisis. J Pediatr Surg 2006; 41 (11) 1830-1835
• 50 Powell WT, Borghese RA, Kalanetra KM, Mirmiran M, Mills DA, Underwood MA. Probiotic administration in infants with gastroschisis: a pilot randomized placebo-controlled trial. J Pediatr Gastroenterol Nutr 2016; 62 (06) 852-857
• 51 Riley M, Goldbach M, Yanowitz T, Morowitz M. Interdisciplinary Collaboration to Reduce Hospital Stay for Neonates with Gastroschisis. PAS Congress abstracts, San Diego, CA; 2015
• 52 Schlatter M, Norris K, Uitvlugt N, DeCou J, Connors R. Improved outcomes in the treatment of gastroschisis using a preformed silo and delayed repair approach. J Pediatr Surg 2003; 38 (03) 459-464 , discussion 459–464
• 53 Sharp M, Bulsara M, Gollow I, Pemberton P. Gastroschisis: early enteral feeds may improve outcome. J Paediatr Child Health 2000; 36 (05) 472-476
• 54 Singh SJ, Fraser A, Leditschke JF. , et al. Gastroschisis: determinants of neonatal outcome. Pediatr Surg Int 2003; 19 (04) 260-265
• 55 Snyder CW, Biggio JR, Brinson P. , et al. Effects of multidisciplinary prenatal care and delivery mode on gastroschisis outcomes. J Pediatr Surg 2011; 46 (01) 86-89
• 56 Tannuri ACA, Sbragia L, Tannuri U. , et al. Evolution of critically ill patients with gastroschisis from three tertiary centers. Clinics (Sao Paulo) 2011; 66 (01) 17-20
• 57 Tannuri ACA, Silva LM, Leal AJG, Moraes AC, Tannuri U. Does administering albumin to postoperative gastroschisis patients improve outcome?. Clinics (Sao Paulo) 2012; 67 (02) 107-111
• 58 Vachharajani AJ, Dillon PA, Mathur AM. Outcomes in neonatal gastroschisis: an institutional experience. Am J Perinatol 2007; 24 (08) 461-465
• 59 van Manen M, Bratu I, Narvey M, Rosychuk RJ. ; Canadian Pediatric Surgery Network. Use of paralysis in silo-assisted closure of gastroschisis. J Pediatr 2012; 161 (01) 125-8.e1
• 60 Walter-Nicolet E, Rousseau V, Kieffer F. , et al. Neonatal outcome of gastroschisis is mainly influenced by nutritional management. J Pediatr Gastroenterol Nutr 2009; 48 (05) 612-617
• 61 Shulman DI, Kanarek K. Gastrin, motilin, insulin, and insulin-like growth factor-I concentrations in very-low-birth-weight infants receiving enteral or parenteral nutrition. JPEN J Parenter Enteral Nutr 1993; 17 (02) 130-133
• 62 Shimizu T, Tadokoro R, Kaneko N. , et al. Effects of extremely early enteral feeding on plasma glicentin levels in very-low-birthweight infants. J Paediatr Child Health 2006; 42 (10) 636-639
• 63 Unger CA, Barber MD. Studying surgical innovations: challenges of the randomized controlled trial. J Minim Invasive Gynecol 2015; 22 (04) 573-582
• 64 Cook JA. The challenges faced in the design, conduct and analysis of surgical randomised controlled trials. Trials 2009; 10 (01) 9
• 65 Ergina PL, Cook JA, Blazeby JM. , et al; Balliol Collaboration. Challenges in evaluating surgical innovation. Lancet 2009; 374 (9695): 1097-1104
• 66 Molik KA, Gingalewski CA, West KW. , et al. Gastroschisis: a plea for risk categorization. J Pediatr Surg 2001; 36 (01) 51-55