Nasogastric Tube vs. Orogastric Feeding Tube in Preterm Infants: Which is Best?

NCT ID: NCT00365703

Last Updated: 2007-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

115 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-09-30

Study Completion Date

2007-08-31

Brief Summary

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The purpose of this study is to find out which method (nasogastric vs. orogastric) of feeding tube for premature infants results in earlier only oral feeding.

Detailed Description

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Preterm infants, even as young as 23 weeks gestational age, can be fed enterally at the first week of life. Coordination of sucking and swallowing, and coordination of both and breathing is necessary for efficient and safe oral feeding, and is not well established before the 35th week gestational age. That is why tube feeding is essential for preterm infants younger than that age.

There is no consensus regarding the best way for the feeding tube, i.e. oral vs. nasal, and whether placing the tube should be continuous or intermittently. Nasogastric tube has been associated with vagal responses. Both tubes may cause gastric perforation.

Development and function of oral feeding has been described. It is known that non-nutritive sucking and early introduction of oral feeding accelerate the transition from tube feeding to oral feeding. It is suggested that the preterm infant may experience a maturational lag in vagal function related to ingestive needs, which may contribute to continued feeding difficulties and may be a measurable marker of subtle neurodevelopmental problems. Both oral and nasal feeding tube may interfere with establishment of efficient oral feeding. The purpose of this study is to see whether there is a difference between oral and nasal tube feeding, regarding the institution of oral feeding.

Conditions

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Infant, Premature

Keywords

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Infant, Premature Tube feeding

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Blinding Strategy

NONE

Study Groups

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1

Orogastric feeding tube.

Group Type EXPERIMENTAL

Feeding tube insertion

Intervention Type PROCEDURE

1. Orogastric feeding tube
2. Nasogastric feeding tube

2

Nasogastric feeding tube.

Group Type EXPERIMENTAL

Feeding tube insertion

Intervention Type PROCEDURE

1. Orogastric feeding tube
2. Nasogastric feeding tube

Interventions

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Feeding tube insertion

1. Orogastric feeding tube
2. Nasogastric feeding tube

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* All preterm infants, born during one year, who required tube feeding, and later discharged from neonatal intensive care unit.

Exclusion Criteria

* Infants who died during hospitalization
* Infants with severe neurologic deficit (e.g. after Sarnat II-III asphyxia, or as a part of a syndrome
* Infants with gastrostomy
* Infants who were transferred to another hospital for any reason (e.g. heart surgery)
Maximum Eligible Age

4 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hillel Yaffe Medical Center

OTHER_GOV

Sponsor Role lead

Responsible Party

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Hillel Yaffe Medical Center

Principal Investigators

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Erez Nadir, MD

Role: PRINCIPAL_INVESTIGATOR

Hillel Yaffe medical cenetr, Hadera, Israel

Locations

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Neonatal intensive care unit, Hille Yaffe medical center

Hadera, Hadera, Israel

Site Status

Countries

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Israel

References

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Lau C, Smith EO, Schanler RJ. Coordination of suck-swallow and swallow respiration in preterm infants. Acta Paediatr. 2003 Jun;92(6):721-7.

Reference Type BACKGROUND
PMID: 12856985 (View on PubMed)

Mizuno K, Ueda A. The maturation and coordination of sucking, swallowing, and respiration in preterm infants. J Pediatr. 2003 Jan;142(1):36-40. doi: 10.1067/mpd.2003.mpd0312.

Reference Type BACKGROUND
PMID: 12520252 (View on PubMed)

Shiao SY, Youngblut JM, Anderson GC, DiFiore JM, Martin RJ. Nasogastric tube placement: effects on breathing and sucking in very-low-birth-weight infants. Nurs Res. 1995 Mar-Apr;44(2):82-8.

Reference Type BACKGROUND
PMID: 7892144 (View on PubMed)

Haxhija EQ, Rosegger H, Prechtl HF. Vagal response to feeding tube insertion in preterm infants: has the key been found? Early Hum Dev. 1995 Mar 17;41(1):15-25. doi: 10.1016/0378-3782(94)01605-o.

Reference Type BACKGROUND
PMID: 7781566 (View on PubMed)

Grunebaum M, Horodniceanu C, Wilunsky E, Reisner S. Iatrogenic transmural perforation of the oesophagus in the preterm infant. Clin Radiol. 1980 May;31(3):257-61. doi: 10.1016/s0009-9260(80)80211-x.

Reference Type BACKGROUND
PMID: 7428263 (View on PubMed)

Arvedson JC, Lefton-Greif MA. Anatomy, physiology, and development of feeding. Semin Speech Lang. 1996 Nov;17(4):261-8. doi: 10.1055/s-2008-1064103.

Reference Type BACKGROUND
PMID: 8979310 (View on PubMed)

Lau C, Schanler RJ. Oral motor function in the neonate. Clin Perinatol. 1996 Jun;23(2):161-78.

Reference Type BACKGROUND
PMID: 8780899 (View on PubMed)

Stevenson RD, Allaire JH. The development of normal feeding and swallowing. Pediatr Clin North Am. 1991 Dec;38(6):1439-53. doi: 10.1016/s0031-3955(16)38229-3.

Reference Type BACKGROUND
PMID: 1945550 (View on PubMed)

Pinelli J, Symington A. Non-nutritive sucking for promoting physiologic stability and nutrition in preterm infants. Cochrane Database Syst Rev. 2001;(3):CD001071. doi: 10.1002/14651858.CD001071.

Reference Type BACKGROUND
PMID: 11686975 (View on PubMed)

Simpson C, Schanler RJ, Lau C. Early introduction of oral feeding in preterm infants. Pediatrics. 2002 Sep;110(3):517-22. doi: 10.1542/peds.110.3.517.

Reference Type BACKGROUND
PMID: 12205253 (View on PubMed)

Fucile S, Gisel E, Lau C. Oral stimulation accelerates the transition from tube to oral feeding in preterm infants. J Pediatr. 2002 Aug;141(2):230-6. doi: 10.1067/mpd.2002.125731.

Reference Type BACKGROUND
PMID: 12183719 (View on PubMed)

Suess PE, Alpan G, Dulkerian SJ, Doussard-Roosevelt J, Porges SW, Gewolb IH. Respiratory sinus arrhythmia during feeding: a measure of vagal regulation of metabolism, ingestion, and digestion in preterm infants. Dev Med Child Neurol. 2000 Mar;42(3):169-73. doi: 10.1017/s001216220000030x.

Reference Type BACKGROUND
PMID: 10755456 (View on PubMed)

Other Identifiers

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17/2006-1-HY-CTIL

Identifier Type: -

Identifier Source: org_study_id