Antroduodenal Motility and Feeding Outcome among Neonatal Extracorporeal Membrane Oxygenation Survivors

Abstract

Feeding difficulties are common among survivors of extracorporeal membrane oxygenation (ECMO). In this study, we characterized antroduodenal motor patterns and feeding outcomes among 10 ECMO survivors. Intestinal motor patterns were recorded in 10 ECMO survivors within 48 hours of the initiation of enteral feeding. Subsequent feeding outcomes were tracked until discharge. We compared the motor patterns of infants achieving full oral feedings by 1 month postnatal age with those who did not achieve full oral feedings by 1 month postnatal age. In infants failing to achieve full oral feedings, duodenal clusters occupied less of the total record (P < 0.05), and clusters had significantly lower amplitude (P < 0.05) than were seen in successful infants. Infants failing to achieve full oral feedings had greater time spent in motor quiescence (P < 0.05) than successful infants. Neither group had migrating motor complexes during fasting or mature duodenal motor responses to feeding. At discharge, six infants with feeding failure were more likely to require tube feeding, and the hospital stay was 3.6 times longer. Intracranial abnormalities were detected by computed tomography scan in five of six infants with feeding failure. Early intestinal dysmotility in infants surviving ECMO is associated with later feeding difficulties and prolonged hospitalization.