EFFICACY OF FEEDING GASTROSTOMY IN INFANTS WITH BRONCHOPULMONARY DYSPLASIA (BDP) AND PROLONGED FAILURE TO THRIVE

Abstract

19 The aim of this retrospective study was to evaluate the efficacy of feeding gastrostomy in infants with severe BPD and persistent failure to thrive, having survived after new high tech intensive care methods (extracorporeal membrane oxygenation, new ventilatory strategies) in the neonatal period. Patients and methods: 15 infants born between 1992 and 1996 presenting with growth retardation associated with gastroesophageal reflux (15/15, and fundoplication: 8/15) foregut dysmotility (7/15) or exhibited oral aversive behavior (7/15) were included in this study at a median age of 12 months (range : 7-24 months). During this period, pulmonary status remained stable for all patients and there was no inadequate oxygenation. Weight/height (W/H), weight/age (H/A), weight/age (W/A) Z scoares and nutritional intake (% RDA) were investigated at discharge of the neonatal unit, referral to the nutrition unit, beginning of enteral nutrition (EN) and after 4 months of EN by a feeding gastrostomy (Table).TableResults : median (range) Conclusion : Infants surviving new high tech intensive care methods are at high risk to develop severe nutritional and gastrointestinal complications. Insufficient oral caloric intake is the main cause of growth retardation in these infants, and gastroesophageal reflux and/or dysmotility may aggravate the negative energy balance. EN via gastrostomy is efficient and well tolerated, and provides improvement of caloric intake and growth. These results suggest that gastrostomy should be considered early in the course of infants presenting malnutrition related to severe BPD and that a multidisciplinary approach is warranted.