Repeatability of Gastric Volume Measurements and Intragastric Content Using Ultrasound in Preterm Infants

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

doi:10.1097/mpg.0000000000000397

Cited by 22 publications

(33 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Infants were recruited as part of a larger study (18). Analysis completed subsequent to recruitment for this study indicated that a sample size of 14 paired meals per milk type was sufficient to detect intraindividual differences in GE.…”

Section: Discussionmentioning

confidence: 99%

“…Fitting of random effects by infant allowed us to control for influences on preterm GE that may differ between subjects including body position, infant age, milk composition, pasteurization, and fortification status (8,21). Nonlinear changes in postprandial time were modeled using time as a 2°polynomial based on our previous work (18). Appropriateness of the final models was assessed with standard residual plots.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2017

View full text Add to dashboard Cite

BackgroundPreterm infants' meals typically progress to higher volumes over time. Knowledge of gastric emptying (GE) responses to differing meal volumes may inform enteral feeding management. We examined the effect of meal volume and composition on preterm GE.MethodsForty infants were studied at 33.3±1.4 (29.7-35.6) weeks postmenstrual age when fully enteral fed (target 150 ml/kg/day). Intraindividual comparisons of GE were made for paired meals of 100% and 75% prescribed volume and identical composition of mother's own milk (n=21) and pasteurized donor human milk (n=19). Serial stomach ultrasound images were used to calculate gastric residual volumes (GRVs) and remaining meal proportions (% meal).ResultsGE was faster in the early postprandial period and slowed over time (P<0.001). Reduced volume meals had slower GE rates and lower GRV (P<0.001). Serial postprandial % meal was similar between reduced and full volume meals (P=0.41). Higher milk casein concentration was associated with slower GE (P=0.04). Complete gastric emptying (GRV=0 ml) was more common in infants fed at 3 h intervals compared with those fed every 2 h (P=0.002).ConclusionEarly postprandial GE is more rapid for larger meal volumes. Stable preterm infants may tolerate feeding of a 3 h meal volume at shorter intervals.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

View full text Add to dashboard Cite

show abstract

“…GE during feed administration has been previously documented in preterm infants. In this study, an average of 20% of feed volume is emptied from the stomach during breastfeeding compared with 10% in preterm [ 92 ]. This is probably due to a more mature GI tract in term infants and the effect of both larger FVs and present pre-feed residuals, which were associated with faster GE rate, but not to the longer feed duration time in term infants or milk composition as no associations were found.…”

Section: Discussionmentioning

confidence: 99%

Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants

et al. 2016

View full text Add to dashboard Cite

Human milk (HM) components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE), a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants (n = 41, 2 and/or 5 mo). Stomach volumes (SV) were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV) was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (−0.07 [−0.10, −0.03], p < 0.001) GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001), and longer GE times (0.24 [0.03, 0.46], p = 0.033). Higher whey protein concentration was associated with higher post-feed SVs (4.99 [0.84, 9.13], p = 0.023). Longer GE time was associated with higher adiponectin concentration (2.29 [0.92, 3.66], p = 0.002) and dose (0.02 [0.01, 0.03], p = 0.005), and lower casein:whey ratio (−65.89 [−107.13, −2.66], p = 0.003). FV and HM composition influence GE and breastfeeding patterns in term breastfed infants.

show abstract

“…Other methods for gastric empting in children have been used such as imaging tests (i.e. magnetic resonance imaging, functional ultrasonography) and imaging procedures, which have had good results; however, the ability to ensure consistency between the studies using this method is less reliable and often require skilled technicians [ 13 , 32 , 33 ]. Therefore, although other proxy methods for gastric emptying in children exist, it would have made any comparisons difficult due to the difference in measurement techniques and varying reliability.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of the impact of feed protein type and degree of hydrolysis on gastric emptying in children

et al. 2015

View full text Add to dashboard Cite

BackgroundThe choice of infant formula is thought to play an important role on gastric emptying (GE) in a variety of gastrointestinal disorders. It is known that many ingredients impact on GE, including the type of protein and level of hydrolysis. In clinical practice, feeds are often recommended due to putative improved GE related to the type of protein and level of hydrolysis, however whether this is scientifically justified still needs to be established. A systematic review comparing the impact of protein type and hydrolysis on GE in children was therefore performed.MethodsThe Patient, Intervention, Comparison and Outcome system was used. A structured literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, searching PubMed, Cochrane databases and Google Scholar from 1990 to 2014. We only included articles published in full text English language using specific search terms, including both scintigraphy and C13-octanoic acid breath test.ResultsWe identified 126 publications of which 20 were eligible for inclusion but only 8 were included. Studies reviewed GE in both healthy children as well as those with neurodevelopmental delay and reflux. Two studies investigating GE of breast milk versus formula indicated a faster GE for breast milk. Four studies found that feeds containing whole whey in varying amounts emptied faster than predominant whole casein feeds and one study found no difference in GE. Five studies investigated a mix of whole versus hydrolysed protein and found conflicting results related to study population and hydrolysis.ConclusionsBreast milk has a faster GE than formula milk. Although there seems to be a trend towards whey feeds emptying faster, different methodologies, feed compositions and patient groups makes it difficult to draw firm conclusions. Future studies should be performed with comparable feeds in populations where increased GE may be of clinical benefit.

show abstract

Repeatability of Gastric Volume Measurements and Intragastric Content Using Ultrasound in Preterm Infants

Cited by 22 publications

References 44 publications

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

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

Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants

Systematic review of the impact of feed protein type and degree of hydrolysis on gastric emptying in children

Contact Info

Product

Resources

About