Gastric Emptying in Newborns and Young Infants

Signer, E; Fridrich, R

doi:10.1111/j.1651-2227.1975.tb03874.x

Cited by 80 publications

(26 citation statements)

References 11 publications

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“…Gastric emptying is delayed in the newborn (43), allowing for longer periods of food digestion than in adults. Furthermore, high fat concentration in gastric contents further delays gastric emptying.…”

Section: Resultsmentioning

confidence: 99%

Fat Digestion in the Newborn

Hamosh¹,

Scanlon²,

Ganot³

et al. 1981

J. Clin. Invest.

173

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A B S T R A C T We have measured lipolytic activity in gastric aspirates obtained at birth in a group of 142 infants. The infants ranged in gestational age from 26 to 41 wk. Lipolytic activity, measured by the hydrolysis of long chain triglyceride ([tri-3H] INTRODUCTIONThe survival of infants with very low birth weight has increased substantially in the last few years. Normally this is a period of rapid intrauterine growth and development of the fetus. To maintain an adequate rate of growth the prematurely born infant suddenly becomes completely dependent upon the absorption of external nutrients. In addition, at birth, with the sudden transfer from the high-carbohydrate nutrition of the fetus (1) to the high-fat diet of the newborn, fat becomes the major energy source for the growing infant (2, 3).Contrary to adults, who absorb >95% of dietary fat, premature infants absorb only 65 to 80% of ingested fat (4). Inadequate lipid absorption in the preterm infant is attributed to low pancreatic lipase activity (5-7) and impaired solubilization of lipids due to low levels of bile salts (7-12). There are, however, marked variations in the efficiency of lipid absorption in the neonate that are attributed to variations in the functional maturity of the gastrointestinal tract at birth (13,14). These individual differences in the ability to digest fat could be the result of variations in the level of intragastric lipolysis (15); infants in whom the latter mechanism is well developed could absorb fat more efficiently.In man (16) and several other species (17) lipolysis is initiated in the stomach by a potent lipase secreted by lingual serous glands (von Ebner) (18)(19)(20). This lipase differs from pancreatic lipase in that it is relatively acid resistant, does not require bile salts for activation, and has a low pH optimum (3-5). Gastric digestion leads to the hydrolysis of 10-30% of the Clinical Investigation, Inc. * 0021-9738/81/03/0838/09 $1.00Volume 67 March 1981 [838][839][840][841][842][843][844][845][846] ingested fat to partial glycerides and FFA (16,19,21

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Section: Resultsmentioning

confidence: 99%

Fat Digestion in the Newborn

Hamosh¹,

Scanlon²,

Ganot³

et al. 1981

J. Clin. Invest.

173

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“…Most drugs appear to be absorbed by passive diffusion, although some drugs and nutrients are absorbed by an active process (13). Two major factors affecting the absorption of drugs are pH-dependent passive diffusion and gastric emptying (14)(15)(16)(17). Both processes demonstrate a variable but age-related trend from birth well into infancy and childhood (15,17).…”

Section: Absorption From the Gastrointestinal Tractmentioning

confidence: 99%

“…Delayed absorption of phenobarbital, phenytoin, acetaminophen, and riboflavin occurs (13,20,21). The rate of gastric emptying during the neonatal period is both variable and prolonged (17). Gestational age and postnatal age both affect gastric emptying rate (17) with prolonged emptying times seen in premature infants.…”

Section: Absorption From the Gastrointestinal Tractmentioning

confidence: 99%

“…Two major factors affecting the absorption of drugs are pH-dependent passive diffusion and gastric emptying (14)(15)(16)(17). Both processes demonstrate a variable but age-related trend from birth well into infancy and childhood (15,17). The neutral gastric pH (pH 6-8) at birth is related to the presence of amniotic fluid in the stomach (14).…”

Section: Absorption From the Gastrointestinal Tractmentioning

confidence: 99%

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Pharmacokinetics in the infant.

Milsap

Jusko

1994

Environ Health Perspect

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Processes controlling the absorption, distribution, metabolism, excretion, and pharmacologic effects of drugs are likely to be immature or altered in neonates and infants. Absorption may be affected by differences in gastric pH and stomach emptying rate. Low serum protein concentrations and higher body water composition can change drug distribution. Drug metabolism enzyme activity is typically reduced in the neonate, but rapidly develops over the first year of life. Renal excretion mechanisms are low at birth, but mature over a few months. Limited data are available on the pharmacodynamics of drugs; infants show greater sensitivity to d-tubocurarine. Developmental changes are rapid during the first weeks and months of life, thus requiring continual modification of drug dosage regimens designed for treating pediatric patients.

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“…The role of extracellular calcium (Ca2+) in the contractile responses was determined by contracting the tissues in a zero-Ca2+ physiologic saline solution and in the presence of nifedipine, a voltage-dependent Ca2+ channel blocker. The results demonstrate the following: I ) tissues from adult animals developed significantly more active force when tested with acetylcholine, bethanechol, and potassium chloride; 2) tissues from the fetal animals were relatively unresponDelayed gastric emptying is a common problem in preterm infants (1,2). The factors underlying this gastroparesis remain unsettled but may involve the neural, hormonal, or myogenic factors that control gastric motility.…”

mentioning

confidence: 82%

Developmental Changes in Gastric Fundus Smooth Muscle Contractility and Involvement of Extracellular Calcium in Fetal and Adult Guinea Pigs

et al. 1994

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Delayed gastric emptying is a common problem in preterm infants. The factors underlying this gastroparesis remain unsettled but may involve immaturity of smooth muscle contraction. The present study was designed to test this hypothesis. Muscle strips from the gastric fundus of fetal and adult guinea pigs were studied in vitro for their contractile response to receptor activation (acetylcholine and bethanechol) and membrane depolarization (potassium chloride). The dose-response curves were analyzed for differences in active force development (kg/cm2). The role of extracellular calcium (Ca2+) in the contractile responses was determined by contracting the tissues in a zero-Ca2+ physiologic saline solution and in the presence of nifedipine, a voltage-dependent Ca2+ channel blocker. The results demonstrate the following: I ) tissues from adult animals developed significantly more active force when tested with acetylcholine, bethanechol, and potassium chloride; 2) tissues from the fetal animals were relatively unresponDelayed gastric emptying is a common problem in preterm infants (1, 2). The factors underlying this gastroparesis remain unsettled but may involve the neural, hormonal, or myogenic factors that control gastric motility. Antral gastric smooth muscle from newborn animals has previously been shown to develop less active force than muscle from adult animals (3-5) and has been demonstrated to undergo a period of postnatal maturation with respect to agonist sensitivity (5), quantity of ca2+ channels (4), and the utilization of ca2+ (4, 6). However, to our knowledge, the contractile properties of the fetal gastric fundus have not been extensively characterized.The purpose of this study was to determine whether differences were present in the force development of the sive to contraction with potassium chloride compared with the adult; and 3) both nifedipine and incubation in a zeroCa2+ physiologic saline solution had a significantly greater inhibitory effect on the contractions of adult than fetal muscle strips. Our data indicate that smooth muscle in the gastric fundus develops increasing force with maturation. The increased contractility in the adult fundus appears to be due to an increased involvement of extracellular calcium influx, in part through voltage-dependent Ca2+ channels. CaZ+, calcium gastric fundus of the adult and third-trimester fetal guinea pig. The in vitro contractile responses of adult and fetal animals to receptor-dependent agonists, ACh and BETH, and a receptor-independent agonist, KCl, were compared. The involvement of extracellular and intracellular ca2+ stores in the contractile response was investigated by I ) contracting the tissues in the presence of nifedipine, a voltage-dependent ca2+ channel blocker, 2) contracting the tissues in a zero-ca2+ PSS, and 3 ) isolating the contribution of intracellular ca2+ sources to contraction. METHODS Tissue PreparationMuscle strips were obtained from the gastric fundus of

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Gastric Emptying in Newborns and Young Infants

Cited by 80 publications

References 11 publications

Fat Digestion in the Newborn

Fat Digestion in the Newborn

Pharmacokinetics in the infant.

Developmental Changes in Gastric Fundus Smooth Muscle Contractility and Involvement of Extracellular Calcium in Fetal and Adult Guinea Pigs

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