Does age affect gastric emptying time? A model‐based meta‐analysis of data from premature neonates through to adults

Abstract

Purpose. Gastric emptying (GE) is often reported to be slower and more irregular in premature neonates than in older children and adults. The aim of this study was to investigate the impact of age and other covariates on the rate of GE. Methods. The effect of age on the mean gastric residence times (MGRT) of liquid and solid food was assessed by analysing 49 published studies of 1457 individuals, aged from 28 weeks gestation to adults. The data were modelled using the nonlinear mixed‐effects approach within NONMEM version 7.2 (ICON, Dublin, Ireland), with evaluation of postnatal age, gestational age and meal type as covariates. A double Weibull function was selected as a suitable model since it could account for the typical biphasic nature of GE. Results. Age was not a significant covariate for GE but meal type was. Aqueous solutions were associated with the fastest emptying time (mean simulated gastric residence time of 45 min) and solid food was associated with the slowest (98 min). Conclusions. These findings challenge the assertion that GE is different in neonates, as compared with older children and adults due to age, and they reinforce the significance of food type in modulating GE. © 2015 The Authors. Biopharmaceutics & Drug Disposition Published by John Wiley & Sons Ltd.

Gastric residual volume after split-dose compared with evening-before polyethylene glycol bowel preparation

“…The data also suggest that the patient groups were similar with regard to all clinical features, except age and method of sedation. Because age has been shown to not affect gastric emptying time 27 , we doubt that a difference in age has any effect on the interpretation of our findings. Conscious sedation was provided to the split-dose group in contrast to anesthesia for those in the overnight fasting group due to the preference of anesthesiology providers at our institution to wait at least 4 hours after the last ingestion of bowel prep.…”

Real fasting times and incidence of pulmonary aspiration in children: Results of a German prospective multicenter observational study

“…Of importance, our study included also emergency cases with a higher risk of pulmonary aspiration. A recent meta‐analysis including 1457 individuals from 28 weeks of gestation to adults found considerable interindividual variations in gastric emptying time, and significant residual volumes of gastric juice are possible even after prolonged fasting. As a consequence, no fasting regimen can guarantee that every child has an empty stomach before induction of anesthesia.…”

Bolus Calculator Settings in Well-Controlled Prepubertal Children Using Insulin Pumps Are Characterized by Low Insulin to Carbohydrate Ratios and Short Duration of Insulin Action Time

“…17 Age does not seem to affect the gastric emptying time in a meta-analysis including the whole age span from neonates to adults. 18 Available data show that preschool children with type 1 diabetes have a significantly lower intake of carbohydrate than a healthy control group (47 vs 54%), in spite of having received advice from a dietitian on the recommended intake being the same as for the general pediatric population. 19 It may be that parents voluntarily, although not recommended by diabetes teams, restrict the amount of carbohydrate in the food, thereby increasing the fat content and increasing the gastric empting time.…”