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 20 November 2017

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News

Enteral feeding of high-risk newborns with umbilical catheters

High-risk newborns with umbilical catheter placement receive concomitant enteral nutrition more frequently than it has been suggested in textbooks or published articles, finds a research team in the latest issue of Pediatrics.

News image

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Concomitant enteral nutrition (EN) during umbilical catheter usage in high-risk newborns is controversial, but support for this practice varies.

In this study, researchers from Norfolk, Virginia, assessed the prevalence of neonatal intensive care units (NICUs) where newborns with umbilical catheter placement receive concomitant EN.

The team surveyed the Medical Directors listed in the American Academy of Pediatrics United States Neonatologist and Perinatologist Directory by mail.

The team recorded the survey responses electronically. The NICU identities were recorded by code to maintain anonymity.

92% of units considered it safe to provide trophic enteral nutrition to newborns with umbilical venous catheters in place.
Pediatrics

Overall, 70% of the surveys were returned.

The team found that 82% of NICUs with training programs were represented, while and 62% of those without were not.

They determined that the medical directors had practiced neonatal medicine for an average of 18.1 years.

Of the NICUs surveyed, 99% reported the placement of umbilical arterial catheters (UACs) and umbilical venous catheters (UVCs).

The researchers found that 92% of units considered it safe to provide trophic EN to newborns with UVCs in place. Of these, 51% practiced this some of the time, and 37% practiced it most of the time.

They also found that for newborns with UACs in place, 30% receive trophic EN most of the time, 49% some of the time, and or none of the time.

Furthermore, of the 80% of NICUs who consider it safe to provide more complete EN to newborns with UVCs in place, 44% practiced this some of the time, and 24% practiced it most of the time.

The team also found that for newborns with UACs in place, more complete EN was provided most of the time in 15%, some of the time in 36%, and none of the time in 49%.

Dr Kenneth Tiffany's team concluded, "Concurrent UVC and UAC usage with EN is more commonly practiced than suggested in textbooks or published articles".

"The relative risk-benefit profiles of these practices remain uncertain secondary to the limited number of controlled clinical observations and to the infrequent occurrence of adverse events".

"A prospective, multicenter, controlled trial would address the continued advisability of these unexpectedly common practices".

Pediatrics 2003; 112(1): 20-3
08 July 2003

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