Oral Feeding Outcome after Analgesic and Sedative Exposure in VLBW Preterm Infant

Mark T. Astoria; Leroy Thacker; Karen D. Hendricks-Muñoz

doi:10.1055/s-0038-1660468

American Journal of Perinatology, Table of Contents

Am J Perinatol 2018; 35(14): 1399-1404
DOI: 10.1055/s-0038-1660468

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Oral Feeding Outcome after Analgesic and Sedative Exposure in VLBW Preterm Infant

Mark T. Astoria

¹Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, Richmond, Virginia

,

Leroy Thacker

²Department of Family and Community Health Nursing, Virginia Commonwealth University School of Nursing, Richmond, Virginia

,

Karen D. Hendricks-Muñoz

¹Division of Neonatal Medicine, Department of Pediatrics, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, Richmond, Virginia

› Author Affiliations

Abstract

Objective The objective of this study was to assess the association of analgesics and sedatives on oral feeding function and need for feeding tube at discharge in the very low birth weight (VLBW) (<1,500 g) preterm infant.

Study Design A retrospective review of surviving inborn infants < 1,500 g and < 32 weeks' gestation (n = 209), discharged between January 1, 2012, and December 31, 2014, from the neonatal intensive care unit identified exposure to analgesic and sedative medications, demographics, medical course, and nasogastric or gastrostomy tube (GT) feeding at discharge. Predictive modeling with logistic regression to identify independent factors associated with discharge on tube feedings.

Results Out of 209, 45 (21.5%) infants received an analgesic/sedative with 23 out of 45 (51.1%) discharged with tube feedings. Infants discharged with tube feedings were born smaller, of younger gestation, with greater SNAPPE-II scores, periventricular leukomalacia, chronic lung disease, postnatal glucocorticoids, lansoprazole, and longer time intubated. After adjusting for covariates, exposure to analgesic/sedatives (fentanyl, midazolam, or morphine) was independently predictive of discharge on tube feedings.

Conclusion Analgesic and sedative exposure in VLBW infants is highly associated with poor oral feeding and need for tube feedings at discharge.

Keywords

premature infant - very low birth weight - sedation - analgesic - dysphagia

Full Text

References

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