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Eur J Pediatr Surg 2017; 27(05): 431-436
DOI: 10.1055/s-0036-1597655
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Predicting Full Enteral Feeding in the Postoperative Period in Infants with Congenital Diaphragmatic Hernia

Carlos Zozaya
1   Department of Neonatology, Hospital Universitario La Paz, Madrid, Spain
,
Miryam Triana
1   Department of Neonatology, Hospital Universitario La Paz, Madrid, Spain
,
Rosario Madero
2   Department of Biostatistics Unit, Hospital Universitario La Paz, Madrid, Spain
3   Instituto de Salud Carlos III, Red de Salud Materno Infantil y Desarrollo-SAMID, Madrid, Spain
,
Steven Abrams
4   Department of Pediatrics, Dell Medical School, The University of Texas, Austin, Texas, United States
,
Leopoldo Martinez
3   Instituto de Salud Carlos III, Red de Salud Materno Infantil y Desarrollo-SAMID, Madrid, Spain
5   Department of Pediatric Surgery, Hospiltal Infantil La Paz, Madrid, Spain
,
Maria Virginia Amesty
5   Department of Pediatric Surgery, Hospiltal Infantil La Paz, Madrid, Spain
,
Miguel Sáenz de Pipaón
1   Department of Neonatology, Hospital Universitario La Paz, Madrid, Spain
3   Instituto de Salud Carlos III, Red de Salud Materno Infantil y Desarrollo-SAMID, Madrid, Spain
› Author Affiliations
Further Information

Publication History

28 July 2016

10 November 2016

Publication Date:
12 January 2017 (online)

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Abstract

Introduction The 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 Methods Demographic, 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.

Results Of 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.

Conclusion Infants 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.

Keywords

congenital diaphragmatic hernia - enteral feeding - newborn infant - nutrition - postoperative complications
 

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