Hospital das Clínicas, Ribeirão Preto, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil.
Physiology & Experimental Medicine Program, Department of Paediatrics and Physiology, The Hospital for Sick Children Research Institute, Peter Gilgan Centre for Research and Learning, University of Toronto, Toronto, Ontario, Canada.
J Pediatr Gastroenterol Nutr. 2018 Sep;67(3):e43-e46. doi: 10.1097/MPG.0000000000001985.
Feeding intolerance, manifesting as increased gastric residual, is a common finding in preterm neonates. Little is known about the regulation of gastric emptying early in life and the extent to which this plays a role in the preterm infants' feeding tolerance. The goal of this study was to evaluate clinically stable 28- to 32-week gestation neonates during the first 4 weeks of life and noninvasively determine their gastric emptying rate.
Ultrasound measurements of gastric milk content volume were obtained from 25 neonates immediately after, 30 and/or 60 minutes following routine gavage feeds. The content emptying rate was calculated from the gastric volume data.
Gastric emptying rate was not postnatal age-dependent, was significantly higher at 30 minutes, whenever compared with 60-minute postfeed and directly proportional to the feed volume. At any postnatal age, the gastric emptying rate was at least 6-fold greater, when comparing the lowest and highest average stomach content volumes.
The gastric emptying rate of preterm infants is content volume-dependent and unrelated to the postnatal age. Given the present findings, further investigation on the gastric residual of preterm infants receiving larger than currently administered feed volumes at the initiation of enteral nutrition, is warranted.
以胃残余量增加为表现的喂养不耐受是早产儿的常见现象。对于生命早期胃排空的调节以及其在早产儿喂养耐受中的作用，人们知之甚少。本研究的目的是评估出生后 28-32 周的临床稳定早产儿在生命的最初 4 周内的情况，并通过非侵入性方法确定其胃排空率。
从 25 名新生儿中获取常规胃管喂养后即刻、30 分钟和/或 60 分钟的胃内奶液容量超声测量值。通过胃容量数据计算内容物排空率。
胃排空率与出生后年龄无关，与 60 分钟后相比，在 30 分钟时显著更高，且与喂养量呈正相关。在任何出生后年龄，与最低和最高平均胃内容物量相比，胃排空率至少高 6 倍。
早产儿的胃排空率与内容物量有关，与出生后年龄无关。鉴于目前的研究结果，对于开始肠内营养时接受大于目前给予的喂养量的早产儿的胃残余物，有必要进行进一步研究。
