OXYGEN TENSION CHANGES DUE TO NONNUTRITIVE SUCKING (NNS) DURING OROGASTRIC TUBE FEEDING

Abstract

We conducted a prospective, controlled, crossover study to determine if NNS affects oxygen tension in premature infants during orogastric (OG) tube feeding. Conclusion: We found that NNS during OG tube feeding significantly raised oxygen tension. Methods: Premature infants fed by OG tube were evaluated by continuous transcutaneous oxygen tension (TcPO2) monitoring during successive feedings. Order of feedings was randomly determined. Each feeding was divided into three periods: 1) baseline (with tube in place), 2) feeding, 3) post feeding (with tube in place). When NNS was provided during feeding it was continued through the post feeding period. All infants were nursed in isolettes on their abdomen with head elevated 15°. Feedings were introduced by gravity. TcPO2 values were recorded on a paper tracing which was shielded from observation. The state of consciousness was scored every 5 minutes. Statistical analysis was done by paired two-tailed t-test. Results: Eleven infants were studied (6 males, 5 females). Mean birth weight was 1514 grams (range 580-2010). Age at time of study ranged from 2.5 to 101 days. The mean TcPO2 was 4.6 mmHg higher with NNS than without (p < .05) due to a 3.4 mmHg increase over baseline with NNS versus a 1.2 mmHg decrease from baseline without NNS. These changes could not be explained by differences in activity or skin perfusion, as measured by monitor power output. Although the difference is clearly statistically significant, the clinical application depends upon the baseline PO2.