Pádua Gisley de, Martinez Edson Zangiacomi, Brunherotti Marisa Afonso de Andrade
Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP.
Arq Gastroenterol. 2009 Oct-Dec;46(4):321-7. doi: 10.1590/s0004-28032009000400014.
The increase of the gastric volume observed in the gavage feeding is likely to cause consequences to the premature newborn, modifying the respiratory indicators.
To investigate the alterations in the cardiorespiratory system of premature newborns submitted to an increase of the gastric volume by gavage feeding, according to four different body positioning methods.
The study is a randomized crossover trial using a sample of 16 newborns with gestational age from 31 to 34 weeks and birth weight less or equal to 2.500 g. The newborns were included in the study if they had from 7 to 10 days of life, feeding by orogastric tube, total volume of 150 mL/kg/day and absence of supplemental oxygen-therapy. A different positioning method was used at each gavage (all raised to 30 degrees), or say, right lateral, left lateral, prone and supine positions. The following response variables were considered: respiratory and cardiac frequencies, saturation of oxygen, drawing of intercostals, beating of nasal wing and grunting. These measures were collected in intervals of 2 minutes during 5 minutes after the gavage feeding, during whole period of the gavage feeding, and during 5 minutes before the gavage feeding.
The mean gestational age was 32 weeks (standard deviation 1.3) and the mean weight of the newborns was 1.722 g (standard deviation 276.3). The newborns presented higher values of the mean respiratory frequency in supine and left lateral body positions. In the right lateral and prone positions, the newborns presented lower mean cardiac frequency. The mean oxygen saturation had the lowest values in the left lateral and supine positions. The right lateral and prone positions presented low frequencies of intercostals drawing, beating of nasal wing and grunting.
Our results indicate that right lateral and prone positions have influence on the cardiorespiratory effect, where left lateral and supine are the positions who presented higher negative effect in the newborns submitted to the increase of the gastric volume.
管饲喂养中观察到的胃容量增加可能会对早产新生儿造成影响，改变呼吸指标。
根据四种不同的体位方法，研究因管饲喂养导致胃容量增加的早产新生儿心肺系统的变化。
本研究是一项随机交叉试验，样本为16名孕周在31至34周、出生体重小于或等于2500克的新生儿。如果新生儿出生7至10天、通过鼻胃管喂养、每日总量为150毫升/千克且未接受补充氧气治疗，则纳入研究。每次管饲时采用不同的体位方法（均抬高至30度），即右侧卧位、左侧卧位、俯卧位和仰卧位。考虑以下反应变量：呼吸频率、心率、血氧饱和度、肋间肌牵拉、鼻翼扇动和呻吟。这些测量值在管饲喂养后5分钟内每隔2分钟收集一次，在整个管饲喂养期间收集，以及在管饲喂养前5分钟收集。
平均孕周为32周（标准差1.3），新生儿平均体重为1722克（标准差276.3）。新生儿在仰卧位和左侧卧位时平均呼吸频率较高。在右侧卧位和俯卧位时，新生儿平均心率较低。左侧卧位和仰卧位时平均血氧饱和度最低。右侧卧位和俯卧位时肋间肌牵拉、鼻翼扇动和呻吟的频率较低。
我们的结果表明，右侧卧位和俯卧位对心肺效应有影响，其中左侧卧位和仰卧位对胃容量增加的新生儿产生的负面影响较大。
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