Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
J Pediatr. 2010 May;156(5):744-8, 748.e1. doi: 10.1016/j.jpeds.2009.11.006. Epub 2010 Jan 25.
To investigate the threshold amount of constantly infused feed needed to trigger lower esophageal sphincter relaxation (TLESR) in the right lateral position (RLP) and left lateral position (LLP).
Eight healthy infants (3 male; gestational age: 32.9 +/- 2.4 weeks; corrected age: 36.1 +/- 1.3 weeks) were studied using an esophageal impedance-manometry catheter incorporating an intragastric infusion port. After tube placement, infants were randomly positioned in RLP or LLP. They were then tube-fed their normal feed (62.5 [40 to 75] mL) at an infusion rate of 160 mL/h. Recordings were made during the feed and 15 minutes thereafter. The study was repeated with the infant in the opposite position.
More TLESRs were triggered in the RLP compared with LLP (4.0 [3.0 to 6.0] vs 2.5 [1.0 to 3.0], P = .027). First TLESR occurred at a significantly lower infused volume in RLP compared with LLP (10.6 +/- 9.4 vs 21.0 +/- 4.9 mL, P = .006). The percentage of feed infused at time of first TLESR was significantly lower in RLP compared with LLP (17.6% +/- 15.5% vs 35.4% +/- 8.02%, P = .005).
In the RLP, TLESRs and gastroesophageal reflux are triggered at volumes unlikely to induce gastric distension.
研究持续输注喂养量触发右侧卧位（RLP）和左侧卧位（LLP）下食管下括约肌松弛（TLESR）的阈值。
使用带有胃内输注端口的食管阻抗测压导管对 8 名健康婴儿（男 3 例；胎龄：32.9 +/- 2.4 周；校正年龄：36.1 +/- 1.3 周）进行研究。放置导管后，婴儿随机置于 RLP 或 LLP。然后以 160 mL/h 的速度以正常喂养量（62.5 [40 至 75] mL）进行管饲。在喂养期间和之后 15 分钟进行记录。将婴儿置于相反位置重复该研究。
RLP 中触发的 TLESR 多于 LLP（4.0 [3.0 至 6.0] 与 2.5 [1.0 至 3.0]，P =.027）。RLP 中首次 TLESR 发生的输注量明显低于 LLP（10.6 +/- 9.4 与 21.0 +/- 4.9 mL，P =.006）。RLP 中首次 TLESR 时的输注量百分比明显低于 LLP（17.6% +/- 15.5% 与 35.4% +/- 8.02%，P =.005）。
在 RLP 中，TLESR 和胃食管反流在不太可能引起胃扩张的体积下被触发。
