VAGAL RESPONSE TO FEEDING TUBE INSERTION IN PRETERM INFANTS - HAS THEKEY BEEN FOUND

We prospectively studied the vagal response to feeding tube insertion in eight healthy preterm infants, on three occasions in each infant du ring the first three weeks of life. Heart rate, oxygen saturation, res piration and cerebral blood flow velocities were assessed before, duri ng and immediately after insertion of an orogastric feeding tube. The whole procedure was recorded on video. The duration and quality of tub e insertion and the behaviour of the infant were evaluated from the re cordings. Twenty-one measurements in eight infants were evaluated, The heart-rate decrease observed immediately after tube insertion correla ted significantly with the duration of tube insertion, the quicker the manipulation, the greater the heart-rate decrease (P = 0.000). The ma ximal decrease of oxygen saturation after tube insertion correlated wi th the degree of heart rate deceleration (P = 0.009), Significant alte rations of the flow velocities were observed only when the heart rate fell below 80 beats/min. We speculate that such episodes of bradycardi a can be avoided by carefully inserting the feeding tube over a period of at least 15 s.