Intermittent Oro-Esophageal Tube Feeding vs. Nasogastric Tube Feeding in Infants With Pierre Robin Syndrome
Condition: Pierre-Robin Syndrome; Dysphagia
MeSH terms: Pierre Robin Syndrome; Deglutition Disorders; Syndrome
Study type: Interventional

Summary: 
      This was a randomized controlled study. The infants enrolled were randomly divided into the
      IOE group (with Intermittent Oro-Esophageal Tube Feeding, n=25) and the PNG group (with
      Nasogastric Tube Feeding, n=23), all receiving systemic therapy. Before and after 4-week
      treatment, pulmonary infection, swallowing function, nutritional status and body weight
      between the two group were compared.
    

Detailed description: 
      Pierre Robin Syndrome (PRS) can cause dysphagia. In China, persistent nasogastric tube
      feeding (PNG) is the mainstream choice as nutrition support in the dysphagic infants with
      PRS. However, PNG is associated with various complications, necessitating the exploration for
      a safer and more effective nutritional support approach. Therefore, this study aims to
      observe the clinical effect of intermittent oro-esophageal tube feeding (IOE) compared to PNG
      in the dysphagic infants with PRS who received systemic therapy.

      This was a randomized controlled study. The infants enrolled were randomly divided into the
      IOE group (with IOE, n=25) and the PNG group (with PNG, n=23), all receiving systemic
      therapy. Before and after 4-week treatment, pulmonary infection, swallowing function,
      nutritional status and body weight between the two group were compared.
    

Intervention name(s): systematic therapy; PNG; IOE
Intervention type(s): Behavioral; Device; Device
Intervention description(s): Both groups were given systematic therapy according to the routine treatment plan for PRS for 4 weeks. The main intervention measures included: 1) non-invasive ventilator treatment, generally at least once every night and typically not exceeding continuous daily usage.; 2) attention to feeding and sleeping positions, with a recommended sleeping position of lateral recumbent and the head of the bed raised by 20-30°; 3) swallowing function training, such as tongue muscle stretching training, assisted anterior jaw protrusion training, lemon ice stimulation to the soft palate, pharyngeal wall, etc., generally 5 days per week, twice per day, 5-20 minutes each time; 4) pulmonary ultrashort wave therapy, generally at least 2-3 times a week, and not more than once a day; 5) physical therapy, such as intensive training for gross motor functions including lifting the head, turning over, sitting, crawling, standing, etc., generally 3-5 days per week, 1-2 times per day, 5-20 min each time.; In PNG group, disposable gastric tubes were used for feeding to provide nutritional support. Each feeding was administered by a nurse using the infant's mother's breast milk through the tube. The amount of each feeding varied from 20 to 100 ml depending on the age of the infant, with feedings given every 2 to 3 hours, approximately 10 times per day. The duration of each feeding procedure ranged from 10 to 20 minutes. The total daily intake ranged from 200 to 1000 ml. Each tube was kept indwelling for 5 to 7 days. When the tube needed to be replaced, it was removed after the last feeding of a day and a new tube was to be inserted through the other nostril on the following morning to continue the nutritional support.; The specific procedure was as follows: the infant was placed in a semi-recumbent or sitting position with the head fixed. Before each feeding, the infant's oral and nasal secretions were to be cleared. An intermittent oro-esophageal tube (Appendix) was appropriately lubricated with water on the head part. The professional medical staff held the tube and slowly inserted it through one side of the mouth into the upper part of the esophagus. The depth of insertion depended on the patient's age and height. After each feeding, the tube was immediately removed, and the patient was held upright for at least 30 minutes in case of reflux.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Infant; Pierre Robin Syndrome; Dysphagia; Rehabilitation