Outcome of Infants Discharged Home from the Neonatal Unit with Partial Nasogastric Feeds

Shivani Kamal; Indira Chandrasekar

doi:doi:10.11648/ijg.20240801.11

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Outcome of Infants Discharged Home from the Neonatal Unit with Partial Nasogastric Feeds

Shivani Kamal, Indira Chandrasekar

Published in International Journal of Gastroenterology (Volume 8, Issue 1)

Received: 12 January 2024 Accepted: 24 January 2024 Published: 5 February 2024

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Abstract

Aim: In our previous publication, we proposed an algorithm for safely discharging infants from the neonatal intensive care unit (NICU) on partial nasogastric feeds (NGF), thus avoiding gastrostomy tube placement (GTP) for infants who were unable to take full oral feeds. This follow up study post intervention, is to determine the number of patients discharged home on partial nasogastric (NG) feeds, the effectiveness of this intervention measured by reaching full oral feeds within 3 months of discharge and parent view on this intervention and outcome. We also investigated the success of this intervention based on the main discharge diagnosis. Study Design: Retrospective single-center study of infants discharged from the NICU from June 2019 to Dec 2020. Chart review was done to determine the rate of follow-up, time of achieve full oral feeds, and discontinuation of NG tube. We calculated NICU days saved by calculating the days from discharge to reaching full oral feeds at home. Results: Patient records were available for chart review regarding their outpatient follow-up in 96%. 82% of patients reached full feeds on an average of 35 days (range 1day to 10 weeks). 10% of patients required GTP due to the need for prolonged gavage feeding. 2 records were unavailable. Infants discharged home with NG tubes saved 587 NICU days. 88% of the parents contacted over phone responded positively in their choice of NG tube instead of GTP. Conclusion: Discharge from NICU on partial NG feeds for select infants is associated with reduced NICU stay without increased post-discharge complications or increased parent satisfaction.

Published in	International Journal of Gastroenterology (Volume 8, Issue 1)
DOI	10.11648/ijg.20240801.11
Page(s)	1-4
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Neonatal Intensive Care Unit, Home Nasogastric Feeds Gastrostomy Tube Placement, Oral Feeds

References

[1]	Chandrasekar I, Ortiz E, Norgaard J, Rojas MA. (2021). Home Nasogastric Tube Feeding in Patients with Traditional Indications for Gastrostomy Tube Placement. International Journal of Gastroenterology, 5(2), 91-95.
[2]	Khalil ST, Uhing MR, Duesing L, Visotcky A, Tarima S, Nghiem-Rao TH. Outcomes of Infants with Home Tube Feeding: Comparing Nasogastric vs Gastrostomy Tubes. JPEN Journal of parenteral and enteral nutrition. 2017. November; 41(8): 1380–5.
[3]	Mago-Shah DD, Malcolm WF, Greenberg RG, Goldstein RF. Discharging Medically Complex Infants with Supplemental Nasogastric Tube Feeds: Impact on Neonatal Intensive Care Unit Length of Stay and Prevention of Gastrostomy Tubes. American journal of perinatology. 2020. June 4.
[4]	White BR, Ermarth A, Thomas D, Arguinchona O, Presson AP, Ling CY. Creation of a Standard Model for Tube Feeding at Neonatal Intensive Care Unit Discharge. JPEN Journal of parenteral and enteral nutrition. 2020. March; 44(3): 491–9.
[5]	Williams SL, Popowics NM, Tadesse DG, Poindexter BB, Merhar SL. Tube feeding outcomes of infants in a Level IV NICU. Journal of perinatology: official journal of the California Perinatal Association. 2019. October; 39(10): 1406–10.
[6]	Matharu P, Cristea AI, Slaven JE, Becker S, Niehaus JZ. Feeding Outcomes for Infants with Bronchopulmonary Dysplasia Discharged on Nasogastric Feeds. American journal of perinatology. 2019. December 30.
[7]	Devin CL, Linden AF, Sagalow E, Reichard KW, Vinocur CD, Miller JM, et al. Standardized pathway for feeding tube placement reduces unnecessary surgery and improves value of care. Journal of pediatric surgery. 2020. June; 55(6): 1013–22.
[8]	Chapman A, George K, Selassie A, Lesher AP, Ryan RM. NICU infants who require a feeding gastrostomy for discharge. Journal of pediatric surgery. 2020. July 29.
[9]	Irving SY, Lyman B, Northington L, Bartlett JA, Kemper C. Nasogastric tube placement and verification in children: review of the current literature. Critical care nurse. 2014. June; 34(3): 67–78. Epub 2014/04/17. eng.
[10]	McAndrew S, Acharya K, Westerdahl J, Brousseau DC, Panepinto JA, et al. A Prospective Study of Parent Health-Related Quality of Life before and after Discharge from the Neonatal Intensive Care Unit. The Journal of Pediatrics. 2019: Oct; 213: 38-45.
[11]	White BR, Zhang C, Presson AP, Friddle K, DiGeronimo R. Prevalence and outcomes for assisted home feeding in medically complex neonates. Journal of pediatric surgery. 2019. March; 54(3): 465–70.
[12]	Ermarth A, Thomas D, Ling CY, Cardullo A, White BR. Effective Tube Weaning and Predictive Clinical Characteristics of NICU Patients With Feeding Dysfunction. JPEN Journal of parenteral and enteral nutrition. 2020. July; 44(5): 920–7.
[13]	Tubbs-Cooley HL, Pickler RH, Meinzen-Derr JK. Missed oral feeding opportunities and preterm infants’ time to achieve full oral feedings and neonatal intensive care unit discharge. American Journal of Perinatology. 2015; 32(1): 1–8.

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APA Style

Kamal, S., Chandrasekar, I. (2024). Outcome of Infants Discharged Home from the Neonatal Unit with Partial Nasogastric Feeds. International Journal of Gastroenterology, 8(1), 1-4. https://doi.org/10.11648/ijg.20240801.11

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ACS Style

Kamal, S.; Chandrasekar, I. Outcome of Infants Discharged Home from the Neonatal Unit with Partial Nasogastric Feeds. Int. J. Gastroenterol. 2024, 8(1), 1-4. doi: 10.11648/ijg.20240801.11

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AMA Style

Kamal S, Chandrasekar I. Outcome of Infants Discharged Home from the Neonatal Unit with Partial Nasogastric Feeds. Int J Gastroenterol. 2024;8(1):1-4. doi: 10.11648/ijg.20240801.11

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@article{10.11648/ijg.20240801.11,
  author = {Shivani Kamal and Indira Chandrasekar},
  title = {Outcome of Infants Discharged Home from the Neonatal Unit with Partial Nasogastric Feeds},
  journal = {International Journal of Gastroenterology},
  volume = {8},
  number = {1},
  pages = {1-4},
  doi = {10.11648/ijg.20240801.11},
  url = {https://doi.org/10.11648/ijg.20240801.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.ijg.20240801.11},
  abstract = {Aim: In our previous publication, we proposed an algorithm for safely discharging infants from the neonatal intensive care unit (NICU) on partial nasogastric feeds (NGF), thus avoiding gastrostomy tube placement (GTP) for infants who were unable to take full oral feeds. This follow up study post intervention, is to determine the number of patients discharged home on partial nasogastric (NG) feeds, the effectiveness of this intervention measured by reaching full oral feeds within 3 months of discharge and parent view on this intervention and outcome. We also investigated the success of this intervention based on the main discharge diagnosis. Study Design: Retrospective single-center study of infants discharged from the NICU from June 2019 to Dec 2020. Chart review was done to determine the rate of follow-up, time of achieve full oral feeds, and discontinuation of NG tube. We calculated NICU days saved by calculating the days from discharge to reaching full oral feeds at home. Results: Patient records were available for chart review regarding their outpatient follow-up in 96%. 82% of patients reached full feeds on an average of 35 days (range 1day to 10 weeks). 10% of patients required GTP due to the need for prolonged gavage feeding. 2 records were unavailable. Infants discharged home with NG tubes saved 587 NICU days. 88% of the parents contacted over phone responded positively in their choice of NG tube instead of GTP. Conclusion: Discharge from NICU on partial NG feeds for select infants is associated with reduced NICU stay without increased post-discharge complications or increased parent satisfaction.},
 year = {2024}
}

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TY - JOUR
T1 - Outcome of Infants Discharged Home from the Neonatal Unit with Partial Nasogastric Feeds
AU - Shivani Kamal
AU - Indira Chandrasekar
Y1 - 2024/02/05
PY - 2024
N1 - https://doi.org/10.11648/ijg.20240801.11
DO - 10.11648/ijg.20240801.11
T2 - International Journal of Gastroenterology
JF - International Journal of Gastroenterology
JO - International Journal of Gastroenterology
SP - 1
EP - 4
PB - Science Publishing Group
SN - 2640-169X
UR - https://doi.org/10.11648/ijg.20240801.11
AB - Aim: In our previous publication, we proposed an algorithm for safely discharging infants from the neonatal intensive care unit (NICU) on partial nasogastric feeds (NGF), thus avoiding gastrostomy tube placement (GTP) for infants who were unable to take full oral feeds. This follow up study post intervention, is to determine the number of patients discharged home on partial nasogastric (NG) feeds, the effectiveness of this intervention measured by reaching full oral feeds within 3 months of discharge and parent view on this intervention and outcome. We also investigated the success of this intervention based on the main discharge diagnosis. Study Design: Retrospective single-center study of infants discharged from the NICU from June 2019 to Dec 2020. Chart review was done to determine the rate of follow-up, time of achieve full oral feeds, and discontinuation of NG tube. We calculated NICU days saved by calculating the days from discharge to reaching full oral feeds at home. Results: Patient records were available for chart review regarding their outpatient follow-up in 96%. 82% of patients reached full feeds on an average of 35 days (range 1day to 10 weeks). 10% of patients required GTP due to the need for prolonged gavage feeding. 2 records were unavailable. Infants discharged home with NG tubes saved 587 NICU days. 88% of the parents contacted over phone responded positively in their choice of NG tube instead of GTP. Conclusion: Discharge from NICU on partial NG feeds for select infants is associated with reduced NICU stay without increased post-discharge complications or increased parent satisfaction.
VL - 8
IS - 1
ER -

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Author Information

Shivani Kamal

Graduate Medical Education, Valley Children's Healthcare, Madera, US
Indira Chandrasekar

Department of Neonatology, Valley Children’s Healthcare, Madera, US

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Plain Text BibTeX RIS

APA Style

Kamal, S., Chandrasekar, I. (2024). Outcome of Infants Discharged Home from the Neonatal Unit with Partial Nasogastric Feeds. International Journal of Gastroenterology, 8(1), 1-4. https://doi.org/10.11648/ijg.20240801.11

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ACS Style

Kamal, S.; Chandrasekar, I. Outcome of Infants Discharged Home from the Neonatal Unit with Partial Nasogastric Feeds. Int. J. Gastroenterol. 2024, 8(1), 1-4. doi: 10.11648/ijg.20240801.11

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AMA Style

Kamal S, Chandrasekar I. Outcome of Infants Discharged Home from the Neonatal Unit with Partial Nasogastric Feeds. Int J Gastroenterol. 2024;8(1):1-4. doi: 10.11648/ijg.20240801.11

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@article{10.11648/ijg.20240801.11,
  author = {Shivani Kamal and Indira Chandrasekar},
  title = {Outcome of Infants Discharged Home from the Neonatal Unit with Partial Nasogastric Feeds},
  journal = {International Journal of Gastroenterology},
  volume = {8},
  number = {1},
  pages = {1-4},
  doi = {10.11648/ijg.20240801.11},
  url = {https://doi.org/10.11648/ijg.20240801.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.ijg.20240801.11},
  abstract = {Aim: In our previous publication, we proposed an algorithm for safely discharging infants from the neonatal intensive care unit (NICU) on partial nasogastric feeds (NGF), thus avoiding gastrostomy tube placement (GTP) for infants who were unable to take full oral feeds. This follow up study post intervention, is to determine the number of patients discharged home on partial nasogastric (NG) feeds, the effectiveness of this intervention measured by reaching full oral feeds within 3 months of discharge and parent view on this intervention and outcome. We also investigated the success of this intervention based on the main discharge diagnosis. Study Design: Retrospective single-center study of infants discharged from the NICU from June 2019 to Dec 2020. Chart review was done to determine the rate of follow-up, time of achieve full oral feeds, and discontinuation of NG tube. We calculated NICU days saved by calculating the days from discharge to reaching full oral feeds at home. Results: Patient records were available for chart review regarding their outpatient follow-up in 96%. 82% of patients reached full feeds on an average of 35 days (range 1day to 10 weeks). 10% of patients required GTP due to the need for prolonged gavage feeding. 2 records were unavailable. Infants discharged home with NG tubes saved 587 NICU days. 88% of the parents contacted over phone responded positively in their choice of NG tube instead of GTP. Conclusion: Discharge from NICU on partial NG feeds for select infants is associated with reduced NICU stay without increased post-discharge complications or increased parent satisfaction.},
 year = {2024}
}

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