Fixação da sonda orogástrica e prontidão para alimentação oral em recém-nascidos pré-termo tardios

Abstract

Breastfeeding is a skill that requires coordinated movements of diverse orofacial structures to occur effectively. In this context, the use of interfaces to fix the orogastric tube on the face is an important fator to be evaluated, as the fixation in locals that leave free the musculature used for breastfeeding provides the effectiveness of muscle action and, thus, the infant’s sucking behavior. The object of study was the fixation of the orogastric tube and its relationship with the oral feeding readiness in late preterm infants who used an orogastric tube for feeding fixed in temporomandibular region. The research aimed to analyze whether the fixation of the orogastric tube in temporomandibular region in late preterm infants optimizes readiness for oral feeding when compared with other types of fixation. This was an observational, longitudinal, prospective, analytical study. Late preterm infants (between 34 and 36 weeks and 6 days of gestational age) using an orogastric tube as an alternative feeding route participated in the study. They were divided into two groups, the exposed group, composed of infants with orogastric tube fixed in temporomandibular region and the non-exposed group, composed of infants using orogastric tube fixed in other regions of the face. The interface area for to fix the orogastric tube was measured daily, as well as a single verification of infant’s facial anthropometric measurements. To avaluate the readiness, two evaluations were realized, with a minimum interval of 24 hours, was used the Preterm Oral Feeding Readiness Scale - PROFAS to direct the evaluation. Fifty-two infants participated in the study, 26 of them infants in each study group. It was observed that, in the beginning of the feeding transition, infants who used the orogastric tube fixed in temporomandibular region presented greater readiness for oral feeding when compared to infants who used fixation in supralabial region, giving a significant difference between the groups (p = 0.05), which didn’t occur in the second evaluation. When the performance items were analyzed separately, the vomiting reflex item presented predominance in the group with tempomandibular fixation (p = 0.05) in the first evaluation. In the second evaluation, alertness behavior was predominant in the temporomandibular group and mild sleep prevails in the supralabial group (p = 0.025). The Consciousness was generally maintained (p = 0.02). It was concluded that the fixation of the orogastric tube in the temporomandibular region in late preterm infants optimizes the readiness for oral feeding when compared with supralabial fixation in the first hours of the feeding transition.