free-drainage gastric tube for NCPAP?

[jriley]

Hi Everyone,
In the North-west of England, we are trying to standardise guidelines within a clinical network (3 x level 3 units + supporting L1+ L2 units). Some units prefer a closed system for OGT for babies on Ncpap whilst others prefer to leave the gastric tube open, attached to a short extension tube and syring thus allowing reflux of feed into the syringe between hourly bolus feeds. However, as we all know, this could present significant risk of aspiration if the tube becomes dislodged.
I'd be interested to know what is your practice and the rationale behind your choice and particularly if you can direct me to evidence as I've sourced just about every database I have access to and can't find anything helpful.:confused:

Thanks, Jill Riley
Neonatal Clinical Educator
Royal Bolton Foundation Hospital
England

[hehady]

We do not use venting NG routinely. Only in babies with CPAP belly syndrome we use a venting NG tube left open into a disposable urine bag. We give feeds every 3 hours. We try to keep the babies in prone position most of the time.

[JoannieO]

Hi there,

In our unit all babies on NCPAP have an orogastric tube in situ for decompression of the stomach as well as for feeding. We give 2 or 3 hourly feeds, depending on the age and tolerance of the baby. If a baby is requiring feeds more frequently than that, we give continuous OG feeds, stopping the feed and aspirating air from the stomach every 4 hours. As long as the nursing staff are vigilant about checking tube placement before feeds ( by gently aspirating or by checking that the tube has not slipped through the tapes) there should not be a problem with aspiration. However, we do not completely empty the stomach at every feed time, this is done 3 hourly if the baby is on 3hrly feeds or 4 hourly if the baby is on 2 hourly feeds. If the baby has significant CPAP belly we cap the tube after the feed for 30 minutes, then open it to air with a syringe on the end. We very rarely have feeds refluxing up the tube with this practice.
Hope this information is useful.

Regards

[p.mansvelt]

Our practice is more or less the same as Joannie`s practice.