A standardized feeding regimen for hypertrophic pyloric stenosis decreases length of hospitalization and hospital costs☆
Section snippets
The pyloric SFR
The pyloric SFR is a feeding schedule developed by consensus of surgeons practicing in our institution and made available through the hospital ordering system (Table 1). 10 mL 5% glucose solution orally Increase by 10 mL every 2 hours to 30 mL In increments of 3 hours: 30 mL ½ strength formula orally 45 mL ½ strength formula orally 60 mL ½ strength formula orally 60 mL full strength formula orally 75 mL full strength formula orally Then ad lib full strength formula orally
Results
Patient demographics for control and SFR groups are presented in Table 2. Empty Cell Control SFR P Value No. of patients studied 94 148 — Age (d) 34.5 ± 16.2 36.9 ± 17.9 .28 Weight (kg) 3.9 ± 0.6 4.0 ± 0.7 .13 Male to female ratio 3.1:1 7.7:1 .01 Premature (%) 12.8 14.9 .71 Comorbid condition (%) 17.0 17.6 1.0 Prophylactic antibiotics (%) 28.7 20.9 .22 Follow-up (%)* 72.3 77.0 .45 *Percentage of patients with at least 1 follow-up visit (usually occurred 1 to 2 weeks after discharge).
Discussion
Several studies have investigated postoperative feeding regimens for HPS patients with respect to time of reintroduction of feeding and speed of advancement in an attempt to discover the safest and most cost-effective method. However, a review of results does not provide any single best technique. However, these studies do appear to support the contention that a more liberal feeding regimen probably does no harm. For example, Turnock and Rangecroft4 evaluated early (4 hour) versus late (18
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Cited by (0)
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Address reprint requests to Kathryn D. Anderson, MD, FACS, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #72, Los Angeles, CA 90027.