Abstract
BackgroundTube feeding is a common procedure in neonatology. In humans, tube misplacement reportedly occurs in up to 59% of all cases and may lead to perforation in 1.1% of preterm intubated neonates. While numerous studies on optimal tube placement have been performed in human neonates, current recommendations on tube feeding in canine and feline neonatology are based, at best, on studies performed in adult animals. Herein, we aimed to test ultrasonography as a tool to verify tube placement in puppies and kittens and to compare different anatomical predictive markers used in human, canine and feline neonates.ResultsThe predictive tube length when held bent between the last rib and the mouth may induce trauma compared to when held straight. A strong positive linear correlation was observed between birthweight and gastric cardia localization. Ultrasonography findings were similar to coeliotomy findings. Stomach volume was less than 2 mL per 100 g in the less-than-one-day-old studied puppies (n = 25) and kittens (n = 28).ConclusionsA weight-based equation was calculated to help predict appropriate tube placement. Ultrasonography can be used to control gastric tube placement, and neonates less than one-day-old have a smaller stomach capacity. Further studies are required to evaluate whether more-than-one-day-old puppies follow the same linear correlation with their weight. Further in vivo studies are warranted to determine the gold standard procedure for tube feeding in neonatal puppies and kittens.
Highlights
Tube feeding is a common procedure in neonatology
Tube measurements in kittens To evaluate the optimal tube length defined as the tip ending in the stomach, regardless of its feeding state without deforming the gastric wall to avoid risks of perforation, bending the tube (BENT) 3⁄4, BENT, STRAIGHT and NEMU were compared to CARDIA US, evaluating whether the tip was within the stomach
These values were compared to MAX US1, evaluating whether the tip was within the empty stomach without risk of perforation and to MAX US2, evaluating whether the tip was within the full stomach without risk of perforation
Summary
Tube feeding is a common procedure in neonatology. Tube misplacement reportedly occurs in up to 59% of all cases and may lead to perforation in 1.1% of preterm intubated neonates. While numerous studies on optimal tube placement have been performed in human neonates, current recommendations on tube feeding in canine and feline neonatology are based, at best, on studies performed in adult animals. Orogastric tube insertion is a common procedure. It allows colostrum or serum intake if canine and feline neonates are unable to suckle colostrum by themselves, preventing enteric diseases, immune deficiency and sepsis [1]. Recommendations are mostly based on procedures performed in adult animals (esophageal versus gastric tubing) [26,27,28]. Other methodologies are used, such as the auscultation of insufflated air [38], carbon dioxide detection [43, 44] and aspiration of gastric content, all of which pose reliability limitations in neonatology [38, 45]
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