Effect of Body Position Changes on Postprandial Gastroesophageal Reflux and Gastric Emptying in the Healthy Premature Neonate - 12/08/11
, Marc A. Benninga, MD, PhD d, John Dent, BChir, PhD, FRACP, FRCP e, Ros Lontis, RN b, Louise Goodchild, RN b, Lisa M. McCall, RN a, Ross Haslam, MB BS, FRACP b, Geoffrey P. Davidson, MB BS, MD, FRACP a, c, Taher Omari, BSc, PhD a, c
Reprint requests: Michiel van Wijk, Academic Medical Centre, Endoscopy Department, Room C2-312, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.Résumé |
Objective |
To identify a body-positioning regimen that promotes gastric emptying (GE) and reduces gastroesophageal reflux (GER) by changing body position 1 hour after feeding.
Study design |
Ten healthy preterm infants (7 male; mean postmenstrual age, 36 weeks [range, 33 to 38 weeks]) were monitored with combined esophageal impedance-manometry. Infants were positioned in the left lateral position (LLP) or right lateral position (RLP) and then gavage-fed. After 1 hour, the position was changed to the opposite side. Subsequently, all infants were restudied with the order of positioning reversed.
Results |
There was more liquid GER in the RLP than in the LLP (median, 9.5 [range, 6.0 to 22.0] vs 2.0 [range, 0.0 to 5.0] episodes/hour; P = .002). In the RLP-first protocol, the number of liquid GER episodes per hour decreased significantly after position change (first postprandial hour [RLP], 5.5 [2.0 to 13.0] vs second postprandial hour [LLP], 0.0 [0.0 to 1.0]; P = .002). GE was faster in the RLP-first protocol than in the LLP-first protocol (37.0 ± 21.1 vs 61.2 ± 24.8 minutes; P = .006).
Conclusions |
A strategy of right lateral positioning for the first postprandial hour with a position change to the left thereafter promotes GE and reduces liquid GER in the late postprandial period and may prove to be a simple therapeutic approach for infants with GER disease.
Le texte complet de cet article est disponible en PDF.Abbreviations : EGJ, GE, GER, GERD, GEt1/2, LES, LLP, PPH, RLP, TLESR
Plan
| Michiel van Wijk was supported by the Ter Meulen Fund (from the Royal Netherlands Academy of Arts and Sciences), the Dutch Digestive Diseases Foundation, and Astra Zeneca. Taher Omari is a member of the advisory board for Sandhill Scientific. Sandhill Scientific had no role in the conception and preparation of this article. |
Vol 151 - N° 6
P. 585 - décembre 2007 Retour au numéro
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