954 Management of the Upper Pouch in Neonates with Oesophageal Atresia: National Survey on Use of Replogle Tubes in United Kingdom

Abstract

Aims: The standard of care for the management of the upper oesophageal pouch is low grade suction applied to a Replogle tube. Availability of Replogle tubes and familiarity of staff with them in units admitting neonates with oesophageal atresia in Britain is unknown. The aim of this study was to obtain such data.

Methods: A questionnaire was designed to obtain information relating to the use of Replogle tubes in neonates with oesophageal atresia. Neonatal units in the United Kingdom were contacted by telephone and questionnaire filled in.

Results: 137 neonatal units were contacted. 100% response rate was obtained. The questionnaire was filled in following a telephone interview with a nurse in 115 (83%) cases and doctor in 23 (17%) cases. 102 (74%) units used a Replogle tube for managing the upper pouch. A ‘nasogastric’ tube was used instead in 21 units and 2 units, used oral suction only. In the remaining 12 units, it was unclear how the upper pouch was drained. Low flow suction was used in conjunction with Replogle tubes in 87% of cases. Guidelines on the use of Replogle tubes were available in 40% of cases. The tube was flushed in 36% of cases and salivary fluid losses were replaced in 31% of cases.

Conclusions: The use of Replogle tubes in Britain is not universal. Units which use Replogle tube have varied practices and use of suction is not routine. In a minority of cases, management is suboptimal. An education programme and practice guidelines would be beneficial.

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