Department of Pediatrics, Pediatric Gastroenterology, East Carolina University, Greenville, North Carolina.
Department of Pediatrics, Division of Neonatology, University of Florida, Gainesville, Florida.
Am J Perinatol. 2024 May;41(S 01):e212-e220. doi: 10.1055/a-1877-6306. Epub 2022 Jun 16.
Enteral feeding tubes are used in neonatal intensive care units (NICUs) to assess feeding tolerance by utilizing preprandial gastric residual aspiration. This study evaluates the effect of gastric residual aspiration on the preterm infant fecal microbiome and gastrointestinal inflammation.
Fifty-one very low birth weight (VLBW) infants (≤32 weeks' gestational age and ≤1,250 g) enrolled in a larger single-center randomized controlled trial evaluating the effects of routine and nonroutine gastric residual aspiration were selected for further analysis. Of those infants, 30 had microbiome analysis performed on stools collected at 6 weeks by sequencing the bacterial V1 to V3 variable regions of the genes encoding for 16S rRNA. In an additional 21 infants, stool samples collected at 3 and 6 weeks were analyzed for intestinal inflammation using a cytokine multiplex panel.
Microbial communities between groups were not distinct from each other and there was no difference in intestinal inflammation between groups. Analyses using gene expression packages DESeq2 and edgeR produced statistically significant differences in several taxa, possibly indicating a more commensal intestinal microbiome in infants not undergoing gastric residual aspiration.
Omission of routine gastric residual aspiration was not associated with intestinal dysbiosis or inflammation, providing additional evidence that monitors preprandial gastric residuals is unnecessary.
· Omission of routine gastric residual aspiration was not associated with intestinal dysbiosis or inflammation.. · Existing literature indicates preprandial gastric aspiration does not reliably correlate with development of necrotizing enterocolitis but does correlate with delayed enteral nutrition.. · Further study is required but this data that suggest monitoring preprandial gastric residuals are unnecessary..
新生儿重症监护病房（NICU）使用肠内喂养管，通过胃残留抽吸来评估喂养耐受性。本研究评估胃残留抽吸对早产儿粪便微生物组和胃肠道炎症的影响。
选择 51 名极低出生体重（VLBW）婴儿（≤32 周胎龄和≤1250g）进行进一步分析，这些婴儿参加了一项更大的单中心随机对照试验，评估常规和非常规胃残留抽吸的效果。其中 30 名婴儿的粪便样本在 6 周时通过对细菌 16S rRNA 编码基因的 V1 至 V3 可变区进行测序进行了微生物组分析。在另外 21 名婴儿中，使用细胞因子多重分析面板分析了在 3 周和 6 周收集的粪便样本中的肠道炎症。
组间微生物群落彼此之间没有明显区别，组间肠道炎症也没有差异。使用基因表达包 DESeq2 和 edgeR 进行的分析在几个分类群中产生了统计学上显著的差异，这可能表明未进行胃残留抽吸的婴儿的肠道微生物组更具共生性。
常规胃残留抽吸的省略与肠道失调或炎症无关，这为监测餐前胃残留是不必要的提供了额外证据。
·常规胃残留抽吸的省略与肠道失调或炎症无关。·现有文献表明，餐前胃抽吸与坏死性小肠结肠炎的发展并不可靠相关，但与肠内营养延迟相关。·需要进一步研究，但这些数据表明监测餐前胃残留是不必要的。
