Changes in gastric emptying in early postnatal life

Carlos, Maria A.; Babyn, Paul; Marcon, Margaret; Moore, Aideen M.

doi:10.1016/s0022-3476(97)70279-8

Cited by 44 publications

(31 citation statements)

References 30 publications

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“…These ultrasound data appear to be in conflict with those from Berseth et al [33] who, using manometry, demonstrated that gastric antral motor activity is similar between term and preterm infants. Our results are not directly comparable with those of Carlos et al [32] because of the different methodologies and the different ages when the infants were studied. We have shown previously in preterm infants that the gastric emptying rate is correlated positively to birth gestational age but not to postnatal age [11] .…”

Section: Discussioncontrasting

confidence: 99%

“…Thus, we anticipated that the feeding outcomes would correlate with gastric emptying. Carlos et al [32] , using ultrasound, suggested a relationship between the time for maximal antral distention and half antral clearance between feeding intolerant and tolerant infants as defined by a GRV 1 50%. These ultrasound data appear to be in conflict with those from Berseth et al [33] who, using manometry, demonstrated that gastric antral motor activity is similar between term and preterm infants.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Potential Factors Predicting Attainment of Full Gavage Feedings in Preterm Infants

Shulman

Smith

2010

Neonatology

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Background: The clinical measures of gastric residuals and abdominal distention are often used to guide feeding in preterm infants, but there are few data demonstrating their usefulness. Similarly, techniques are now available to investigate gastrointestinal (GI) function noninvasively and safely, but their ability to predict attainment of full gavage feedings and/or feeding volume in preterm infants is unclear. Objective: We sought to determine prospectively the potential relationships of attainment of full gavage feedings and feeding volume with clinical measures and noninvasive GI tests. Methods: Fifty preterm infants were followed prospectively. Daily tally was taken of gavage feeding intake, gastric residual volumes (GRVs; milliliters per day, number of GRVs >50% of the previous feeding volume, and number of GRVs >2 ml/kg), and abdominal distention. Infants underwent repeated measurement of lactase activity, GI permeability, fecal calprotectin concentration, and gastric emptying. Results: The number of GRVs >2 ml/kg tended to decrease with postnatal age (p = 0.06). Lactase activity and feeding volume in milliliters per kilogram per day prior to achieving full feedings were correlated (p = 0.007, β = 0.164). There was no correlation between feeding outcomes and GRV (ml/day), GRV >50%, GRV >2 ml/kg, small bowel, colonic, or whole bowel permeability, fecal calprotectin concentration, gastric emptying, or abdominal distention. Conclusions: GRV is unreliable in predicting attainment of full gavage feeding. Lactase activity is related to feeding volume. However, other noninvasive GI tests utilized were not predictive. These data cast doubt upon the utility of GRV in guiding feeding therapy. Randomized trials of different GRV management protocols are needed.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of Potential Factors Predicting Attainment of Full Gavage Feedings in Preterm Infants

Shulman

Smith

2010

Neonatology

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“…Destes, nove foram excluídos: exames não padronizados ou com duração inferior a 18 horas (n = 4), uso de drogas (n = 2), malformação congênitas do tubo digestório (n = 1) e nascimento fora do serviço (n = 1 , ocorreram vários dias ou semanas antes do início da suspeita clínica de DRGE (o estudo de pH foi realizado com cerca 7 semanas, em média, após o nascimento). A intolerância alimentar é conseqüente a uma desordem motora do tubo digestivo relacionada a um padrão motor intestinal de jejum e pós-alimentar muito imaturo 23 e a retardo de esvaziamento gástrico [24][25][26] . O principal mecanismo implicado na fisiopatologia da DRGE, em RNPT, são os relaxamentos transitórios associados a refluxos ácidos induzidos por aumentos da pressão intra-abdominal 27,28 .…”

Section: Resultsunclassified

Risk factors for gastroesophageal reflux disease in very low birth weight infants with bronchopulmonary dysplasia

Mendes¹,

Mezzacappa²,

Toro³

et al. 2008

J Pediatr (Rio J)

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ResumoObjetivo: Conhecer os fatores de risco para a doença por refluxo gastroesofágico (DRGE) em recém-nascidos de muito baixo peso com displasia broncopulmonar. Métodos:Realizou-se um estudo caso-controle incluindo 23 casos e 23 controles com displasia broncopulmonar, sendo realizada investigação por monitorização prolongada do pH esofágico no período de janeiro de 2001 a outubro de 2005. Para cada caso, selecionou-se um controle, e foram comparados pela idade gestacional, peso ao nascimento, gênero, uso de corticóide pré-natal, tempo de ventilação assistida, tempo de oxigenoterapia, tempo de uso de sonda gástrica, uso de xantinas, idade pós-conceptual e peso durante a monitorização do pH esofágico. Realizou-se a análise por regressão logística múltipla para estabelecer o odds ratio (OR) com intervalo de confiança de 95% (IC95%). Resultados:Os dois grupos (com e sem DRGE) não apresentaram diferenças significativas em relação às variáveis demográficas e de evolução pós-natal, uso de corticóide pré e pós-natal, bem como ao tempo de uso de cafeína, ventilação mecânica e oxigenoterapia. Entretanto, as variáveis intolerância alimentar (OR = 6,55; IC95% 1,05-40,8) e tempo de uso de sonda gástrica (OR = 1,67; IC95% 1,11-2,51) comportaram-se como fatores de risco para DRGE. A variável idade pós-conceptual ao exame de monitorização do pH (OR = 0,02; IC95% < 0,001-0,38) comportou-se como fator protetor para DRGE. Conclusão:Os dados obtidos permitem inferir que o tempo prolongado de uso de sonda gástrica e a intolerância alimentar aumentam a probabilidade para DRGE. Já a maior idade pós-conceptual ao exame diminui a chance para DRGE em prematuros com menos de 1.500 g com displasia broncopulmonar. J Pediatr (Rio J). 2008;84(2):154-159:Monitorização prolongada do pH esofágico, displasia broncopulmonar, doença do refluxo gastroesofágico, refluxo gastroesofágico, recém-nascido de muito baixo peso, prematuro. (OR = 1.67; 95%CI 1.11-2.51) turned out to be risk factors for GERD. Postconceptual age at the time of pH monitoring (OR = 0.02; 95%CI < 0.001-0.38) was regarded as a protective factor against GERD. Conclusion:The data obtained allow inferring that prolonged gastric tube use and feeding intolerance increase the risk for GERD. On the other hand, older postconceptual age at the time of pH monitoring reduces the risk for GERD in preterm infants with bronchopulmonary dysplasia weighing less than 1,500 g. (Rio J). 2008;84(2):154-159: 24-hour Artigo submetido em 18.10.07, aceito em 26.12.07. J Pediatr

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“…Feeding intolerance results from a motor digestive disorder related to a very immature fasting and postprandial intestinal movement pattern 23 and to delayed gastric emptying. [24][25][26] Transient relaxations of lower esophageal sphincter (LES) associated with acid reflux caused by an increase in intra-abdominal pressure is the major mechanism implied in the pathophysiology of GERD in preterm infants. 27,28 Even if some doubt is raised about delayed gastric emptying as an additional mechanism in the genesis of GERD, 27,28 for some individuals, delayed gastric emptying may be the triggering mechanism for transient relaxation.…”

Section: Discussionmentioning

confidence: 99%

Fatores de risco para a doença por refluxo gastroesofágico em recém-nascidos de muito baixo peso portadores de displasia broncopulmonar

Mendes¹,

Mezzacappa²,

Toro³

et al. 2008

J. Pediatr. (Rio J.)

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Objective: To assess risk factors for gastroesophageal reflux disease (GERD) in very low birth weight infants with bronchopulmonary dysplasia. Methods:A case-control study was carried out in 23 cases and 23 control subjects with bronchopulmonary dysplasia submitted to 24-hour esophageal pH monitoring between January 2001 and October 2005. Cases and controls were compared for gestational age, birth weight, gender, use of antenatal steroids, duration of assisted ventilation, duration of oxygen therapy, length of gastric tube use, administration of xanthines, postconceptual age, and weight at esophageal pH monitoring. Multiple logistic regression analysis was used to establish the odds ratio (OR) with a 95% confidence interval (95%CI).Results: None of the groups (with and without GERD) showed statistically significant differences in terms of demographic variables and postnatal outcome, use of antenatal and postnatal corticosteroids, or in terms of caffeine use and duration of mechanical ventilation and oxygen therapy. However, feeding intolerance (OR = 6.55; 95%CI1.05-40.8) and length of gastric tube use (OR = 1.67; 95%CI 1.11-2.51) turned out to be risk factors for GERD.Postconceptual age at the time of pH monitoring (OR = 0.02; 95%CI < 0.001-0.38) was regarded as a protective factor against GERD. Conclusion:The data obtained allow inferring that prolonged gastric tube use and feeding intolerance increase the risk for GERD. On the other hand, older postconceptual age at the time of pH monitoring reduces the risk for GERD in preterm infants with bronchopulmonary dysplasia weighing less than 1,500 g. (Rio J). 2008;84(2):154-159: 24-hour esophageal pH monitoring, bronchopulmonary dysplasia, gastroesophageal reflux disease, gastroesophageal reflux, very low birth weight infants, preterm infants. J Pediatr

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Changes in gastric emptying in early postnatal life

Cited by 44 publications

References 30 publications

Evaluation of Potential Factors Predicting Attainment of Full Gavage Feedings in Preterm Infants

Evaluation of Potential Factors Predicting Attainment of Full Gavage Feedings in Preterm Infants

Risk factors for gastroesophageal reflux disease in very low birth weight infants with bronchopulmonary dysplasia

Fatores de risco para a doença por refluxo gastroesofágico em recém-nascidos de muito baixo peso portadores de displasia broncopulmonar

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