The incidence of septic complications in newborns on extracorporeal membrane oxygenation is not affected by feeding route

Purpose: The aim of this study was to compare the effects of enteral and to tal parenteral feeding on septic complications in neonates on extracorporea l membrane oxygenation (ECMO). Methods: Ninety-six neonates were on ECMO between January 1992 and February 1998. Matching for diagnosis and exclusion of neonates with sepsis before ECMO or undergoing surgery on ECMO left 16 enterally fed neonates (cases) a nd 35 parenterally fed neonates (controls) for analysis. Septic complicatio ns were scored using the criteria of the Society of Critical Care Medicine and the American College of Chest Physicians adapted to children. Results: Both groups were comparable with respect to gestational age, sex, and age at initiation of ECMO. The frequency of septic complications did no t differ between cases and controls: no complications, 75% versus 69%; syst emic inflammatory response syndrome, 13% versus 6%; bacteremia, 6% versus 1 4%; sepsis, 6% versus 11%. There were no complications associated with ente ral feeding. The ECMO run was significantly longer in the case group (media n, 161 v 111 hours; P = .01) and mortality rate was lower in the case group (0 v 14%; P = .17). Conclusions: Enteral nutrition does not affect the risk of sepsis in neonat es on ECMO when compared with total parenteral nutrition. Enteral nutrition is well tolerated and not associated with adverse effects. Copyright (C) 2 001 by W.B. Saunders Company.