Gastric emptying of different meal volumes of identical composition in preterm infants: a time series analysis

Perrella, Sharon L.; Hepworth, Anna R.; Gridneva, Zoya; Simmer, Karen; Hartmann, Peter; Geddes, Donna T.

doi:10.1038/pr.2017.292

Cited by 11 publications

(20 citation statements)

References 25 publications

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“…Contrarily, Ramirez et al [ 31 ], reported that gastric emptying time is related to gestational age at birth even at age one month and not to milk osmolality, volume or density in a study of preterm neonates with GA 25–30 weeks. At the same conclusion came Perella et al [ 32 ] when she studied preterm neonates at 33.3 ± 1.4 weeks postmenstrual age with full enteral feeding.…”

Section: Discussionmentioning

confidence: 58%

Caffeine and Gastric Emptying Time in Very Preterm Neonates

Gounaris

Grivea

Baltogianni

et al. 2020

JCM

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Background: Caffeine has been commonly used for prevention and treatment of apnea-related symptoms in premature infants. However, its side effects have not been thoroughly studied. We investigated whether caffeine affects gastric motility in very-preterm (VP) neonates. Methods: The study is a randomized crossover clinical trial. Twenty-two neonates with mean birth weight (BW) (standard deviation—SD) 1077 (229) g and mean gestational age (GA) (SD) 28.6 (2.1) weeks were recruited. Each neonate had its gastric emptying time checked twice with ultrasound assessment of changes in antral cross sectional area (ACSA). All neonates were sequentially allocated to the caffeine group (A) and the control group (B). Complications from the gastrointestinal tract were documented throughout the study. Results: Statistically significant difference was found with regards to the gastric emptying time [median, (range)] between caffeine and control group (p = 0.040). Additionally, in the neonates with BW 1000–1500 g and GA ≥ 28 weeks, the gastric emptying time (minutes) was significantly longer during caffeine treatment [44.5 (36–68.2)] and [40 (34.5–66.5)] respectively, as compared to the gastric emptying time during no caffeine treatment [27 (24.2–30)] (p = 0.002) and [27 (24.5–30)] (p = 0.001). The incidence of gastrointestinal (GI) complications was significantly greater in neonates receiving caffeine [6 (27.%)] as compared with those without caffeine treatment [1 (4.6%)] (p = 0.039). Conclusions: During caffeine treatment, a significantly delayed gastric emptying time was noted in all study neonates, especially in these with BW 1000–1500 g and those with GA ≥ 28 weeks. Further larger studies are necessary in order to confirm this interesting finding.

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Section: Discussionmentioning

confidence: 58%

Caffeine and Gastric Emptying Time in Very Preterm Neonates

Gounaris

Grivea

Baltogianni

et al. 2020

JCM

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“…The gastric antrum was scanned in the epigastric sagittal plane, in the supine and/or in the right lateral decubitus position, for qualitative assessment and/or for the measurement of the antral cross-sectional area. In some studies, a longitudinal scan of the stomach was performed, allowing measurement of 3 diameters (anteroposterior, transverse, and longitudinal axes) for the calculation of the spheroid stomach volume ( 43 , 44 , 46 ). Repeated measurements minimize intra-rater variability.…”

Section: Gastric Emptyingmentioning

confidence: 99%

Gastric Point-of-Care Ultrasound in Acutely and Critically Ill Children (POCUS-ped): A Scoping Review

et al. 2022

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IntroductionPoint-of-care ultrasound (POCUS) use is increasing in pediatric clinical settings. However, gastric POCUS is rarely used, despite its potential value in optimizing the diagnosis and management in several clinical scenarios (i.e., assessing gastric emptying and gastric volume/content, gastric foreign bodies, confirming nasogastric tube placement, and hypertrophic pyloric stenosis). This review aimed to assess how gastric POCUS may be used in acute and critically ill children.Materials and MethodsAn international expert group was established, composed of pediatricians, pediatric intensivists, anesthesiologists, radiologists, nurses, and a methodologist. A scoping review was conducted with an aim to describe the use of gastric POCUS in pediatrics in acute and critical care settings. A literature search was conducted in three databases, to identify studies published between 1998 and 2022. Abstracts and relevant full texts were screened for eligibility, and data were extracted, according to the JBI methodology (Johanna Briggs Institute).ResultsA total of 70 studies were included. Most studies (n = 47; 67%) were conducted to assess gastric emptying and gastric volume/contents. The studies assessed gastric volume, the impact of different feed types (breast milk, fortifiers, and thickeners) and feed administration modes on gastric emptying, and gastric volume/content prior to sedation or anesthesia or during surgery. Other studies described the use of gastric POCUS in foreign body ingestion (n = 6), nasogastric tube placement (n = 5), hypertrophic pyloric stenosis (n = 8), and gastric insufflation during mechanical ventilatory support (n = 4). POCUS was performed by neonatologists, anesthesiologists, emergency department physicians, and surgeons. Their learning curve was rapid, and the accuracy was high when compared to that of the ultrasound performed by radiologists (RADUS) or other gold standards (e.g., endoscopy, radiography, and MRI). No study conducted in critically ill children was found apart from that in neonatal intensive care in preterms.DiscussionGastric POCUS appears useful and reliable in a variety of pediatric clinical settings. It may help optimize induction in emergency sedation/anesthesia, diagnose foreign bodies and hypertrophic pyloric stenosis, and assist in confirming nasogastric tube placement, avoiding delays in obtaining confirmatory examinations (RADUS, x-rays, etc.) and reducing radiation exposure. It may be useful in pediatric intensive care but requires further investigation.

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“…It is possible that the effect of pasteurization or frozen storage alters components of donor HM and so counters the effects of casein and lactose on emptying. Holder pasteurization also causes complete inactivation of the bile salt stimulated lipase (BSSL) and lipoproteinlipase [ 202 ]. Bile salt stimulated lipase enables almost complete hydrolysis of HM triacylglycerol through its synergistic action with pancreatic lipase-related protein 2 [ 203 ].…”

Section: Preterm Infantsmentioning

confidence: 99%

25 Years of Research in Human Lactation: From Discovery to Translation

et al. 2021

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Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach has allowed the translation of the findings with respect to education, and clinical practice. It also sets a foundation for improved study design for future investigations in human lactation.

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Gastric emptying of different meal volumes of identical composition in preterm infants: a time series analysis

Cited by 11 publications

References 25 publications

Caffeine and Gastric Emptying Time in Very Preterm Neonates

Caffeine and Gastric Emptying Time in Very Preterm Neonates

Gastric Point-of-Care Ultrasound in Acutely and Critically Ill Children (POCUS-ped): A Scoping Review

25 Years of Research in Human Lactation: From Discovery to Translation

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