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Matthew Campbell
Matthew Campbell

Buy Infant Feeding Tube



A well secured endotracheal tube is very essential for the safe conduct of anesthesia. In maxillofacial surgeries, providing secure fixation of the nasotracheal tube has always been a problem. We have used an infant feeding tube that goes around the nasal septum for the fixation of the nasal endotracheal tube. This method of securing the nasotracheal tube does not hinder the surgical access, is well tolerated by patients, and is safe.




buy infant feeding tube


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There is growing evidence that less invasive surfactant administration (LISA) is a better alternative to the standard Intubate-surfactant-extubate (InSurE) procedure in spontaneously breathing preterm infants with RDS. The infant feeding tube is easily available and cost-effective in comparison to special catheters used for surfactant administration in various studies on LISA and cost-effective health care is the need of the hour for countries like ours which are Low and middle-income countries(LMICs).The present study was planned to compare the total duration of respiratory support in preterm babies between 26 to 34 weeks of gestation with RDS requiring surfactant therapy administered by LISA technique using an infant feeding tube or InSurE method. In this unblinded randomised controlled trial, 150 infants were allocated to LISA (n = 74) or InSurE group (n = 76). An 8F feeding tube was used for surfactant delivery in the LISA group. The primary outcome was the total duration of respiratory support required and secondary outcomes included the proportion of babies developing BPD, IVH, PDA, NEC, ROP, air leaks, CPAP failure, and those requiring a repeat dose of surfactant along with the duration of hospitalization, time to regain birth weight and Death. The baseline variables including birth weight and gestation age were similar in the two groups. Nearly 27% of the mothers did not receive any dose of antenatal steroids (ANS) while around 37% of the mothers received complete course of ANS. A high proportion of babies (57%) were delivered by cesarean section. Intrapharyngeal reflux was significantly more in babies who received surfactant with the LISA method in comparison to InSurE technique (32% v/s 3%, p


The feeds are concentrated. They can sometimes cause bloating and diarrhoea. You might need to have your feeds at a slower rate if this happens. It is common to start slowly and then build up the amount gradually. Your dietitian might also change the type of feeding you are having.


A nurse or a doctor puts the tube in. It is not pleasant but is a quick procedure. A nasogastric tube doesn't affect your ability to breathe or speak. You can still eat and drink with the tube in place unless your medical team tell you not to do so.


To put a PEJ tube in you have an endoscopy. That means the surgeon puts a tube with a camera on the end through your mouth. The tube goes down your food pipe and into your stomach. This way, they can see where to place the PEJ tube. The surgeon then puts the jejunostomy tube through an opening in the tummy (abdomen) and into your jejunum. You have sedation for this procedure.


To put a PEG tube in, you have an endoscopy. That means the surgeon puts a tube with a camera on the end through your mouth. The tube goes down your food pipe and into your stomach. This way, they can see where to place the PEG tube. The surgeon then puts the tube through an opening in the tummy (abdomen) and into your stomach. You have sedation for this procedure.


You might need to go on using these methods of feeding after you leave the hospital. This may feel frightening at first, but most people get used to it. Try not to worry about it. You will have support.


This infant feeding tube is medical grade, helping to supplement babies without interfering with breastfeeding. This feeding tube can be used with a container for breastmilk or formula such as a bottle or larger syringe. Tube can be inserted in the corner of baby's mouth directly at the breast, or can be used for finger-feeding. Tubes are compatible with all oral syringes. A syringe is necessary to use with the feeding tube for cleaning purposes (syringes sold separately). These tubes are designed to be used on short-term basis of no more than two weeks.


Respiratory distress syndrome (RDS) is a common neonatal condition in preterm infants. Early nasal CPAP and selective administration of surfactant via the endotracheal tube are widely used in the treatment of RDS in preterm infants1. There is growing evidence that LISA/MIST is a better alternative to the InSurE procedure in spontaneously breathing preterm infants with RDS. In a recent systematic review, Isayama et al. have described that LISA decreased the need for mechanical ventilation as well as reduced the incidence of intraventricular hemorrhage and bronchopulmonary dysplasia2. The infant feeding tube is easily available in all NICUs and is far more cost-effective in comparison to special catheters used previously in various studies on LISA3. There is a dearth of studies on LISA from low- and middle-income countries where the availability and cost of special catheters may pose challenges in the implementation of LISA/MIST. The present study was planned to evaluate the effect of administering surfactant by LISA method using an 8F orogastric feeding tube over the traditional InSurE method on the duration of mechanical ventilation and other modalities of respiratory support.


The infants were randomized into the LISA or InSurE group within six hours of birth using opaque sealed envelopes to ensure allocation concealment. Blinding of the investigators or primary caregivers was not possible due to the nature of the intervention. Gestational age assessment was based on the last menstrual period and an early dating scan, or on the Expanded New Ballard score if the former were unavailable or had a discrepancy of 2 weeks or more.


The procedure was performed in the NICU by a trained neonatologist and a staff nurse. Before the LISA procedure, the infant was positioned in the sniffing position. Heart rate and SpO2 were monitored throughout the procedure. Direct laryngoscopy was performed and an 8 Fr feeding tube was inserted to the desired depth without the use of Magill forceps or removal of the CPAP interface. The required tip to lip length was calculated as weight in kilograms plus 6 cm as per our prevalent NICU method. Due to technical difficulty in visualizing the exact length of the feeding tube beyond the vocal cord, we used the tip to lip length for LISA.


In InSurE procedure, the infant was positioned as per standard intubation procedure. Laryngoscopy and intubation were done after the removal of the CPAP mask/prongs. The feeding tube was prepared for desired depth as per the selected endotracheal tube before surfactant administration. Once the endotracheal tube (ET) position was adjudged to be at the correct position, the syringe filled with the surfactant was attached to a feeding tube which was now inserted into the ET to the desired depth. The total dose of surfactant was instilled in four equal aliquots. Bag and tube ventilation was done in between the aliquots of surfactant. After completion of surfactant administration, the endotracheal tube was immediately removed and the baby was shifted back to CPAP with mask/prongs4.


Kanmaz et al., in their RCT administered porcine surfactant in a dose of 100 mg/Kg as a single bolus over a minute using a 5F feeding tube and reported 21% reflux episodes in the LISA group, which were significantly higher in comparison to the InSurE group (10%) and 18% of babies had desaturation in the LISA group11. Heidarzadeh et al. in their study from Iran also reported statistically significant reflux during surfactant administration using thin catheter in comparison to the standard InSurE technique15.


In the present study, we used Beractant (Survanta) at a dose of 100 mg/kg (4 ml/kg) over 4 minutes. Curosurf is more concentrated in comparison to Survanta so the required volume for the same dose of surfactant is lesser with Curosurf in comparison to Survanta. Although, majority of studies on LISA have used Curosurf as the surfactant, Kribs et al. used Survanta successfully in their study on the feasibility of surfactant administration in spontaneously breathing extremely premature infants on nCPAP16.


In the present study despite the need to use a larger volume of surfactant preparation (Survanta) the numbers of reflux episodes were similar and comparable to the studies from the developed countries in which more concentrated preparation of surfactant (Curosurf) was used requiring smaller volume to achieve the same dose. In the present study, we have used a comparatively wider bore tube as compared to other studies so as to be able to administer the requisite volume of surfactant.


There was a trend toward reduced requirement of antibiotics in the intervention group although the results were not statistically significant. In this study, the length of hospital stay was also shorter in the LISA group although the results were not statistically significant but the reduction of seven days of hospital stay is clinically quite significant and has a major social and economic impact, especially in the backdrop of LMIC. The early discharge is influenced by several factors which include complications occurring during NICU stay (sepsis, feeding problems), social factors (parental presence and involvement), and public health factors19. 041b061a72


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