Efficacy and safety of mucous fistula refeeding in preterm infants: an exploratory randomized controlled trialopen access
- Authors
- Lee, E.S.; Kim, E.-K.; Shin, S.H.; Jung, Y.H.; Song, I.-G.; Kim, Y.-J.; Kim, H.Y.; Choi, Y.-H.; Moon, K.C.; Kim, B.
- Issue Date
- Mar-2023
- Publisher
- NLM (Medline)
- Keywords
- Citrulline; Enterostomy; Mucous fistula refeeding; Necrotizing enterocolitis; Preterm infants; Randomized controlled trial; Short bowel syndrome
- Citation
- BMC pediatrics, v.23, no.1, pp 137
- Journal Title
- BMC pediatrics
- Volume
- 23
- Number
- 1
- Start Page
- 137
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/68488
- DOI
- 10.1186/s12887-023-03950-1
- ISSN
- 1471-2431
1471-2431
- Abstract
- BACKGROUND: This study aimed to evaluate whether mucous fistula refeeding (MFR) is safe and beneficial for the growth and intestinal adaptation of preterm infants with enterostomies. METHODS: This exploratory randomized controlled trial enrolled infants born before 35 weeks' gestation with enterostomy. If the stomal output was ≥ 40 mL/kg/day, infants were assigned to the high-output MFR group and received MFR. If the stoma output was < 40 mL/kg/day, infants were randomized to the normal-output MFR group or the control group. Growth, serum citrulline levels, and bowel diameter in loopograms were compared. The safety of MFR was evaluated. RESULTS: Twenty infants were included. The growth rate increased considerably, and the colon diameter was significantly larger after MFR. However, the citrulline levels did not significantly differ between the normal-output MFR and the control group. One case of bowel perforation occurred during the manual reduction for stoma prolapse. Although the association with MFR was unclear, two cases of culture-proven sepsis during MFR were noted. CONCLUSIONS: MFR benefits the growth and intestinal adaptation of preterm infants with enterostomy and can be safely implemented with a standardized protocol. However, infectious complications need to be investigated further. TRIAL REGISTRATION: clinicaltrials.gov NCT02812095, retrospectively registered on June 6, 2016. © 2023. The Author(s).
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