Document Detail

Evaluation of potential factors predicting attainment of full gavage feedings in preterm infants.
MedLine Citation:
PMID:  20588069     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The clinical measures of gastric residuals and abdominal distention are often used to guide feeding in preterm infants, but there are few data demonstrating their usefulness. Similarly, techniques are now available to investigate gastrointestinal (GI) function noninvasively and safely, but their ability to predict attainment of full gavage feedings and/or feeding volume in preterm infants is unclear.
OBJECTIVE: We sought to determine prospectively the potential relationships of attainment of full gavage feedings and feeding volume with clinical measures and noninvasive GI tests.
METHODS: Fifty preterm infants were followed prospectively. Daily tally was taken of gavage feeding intake, gastric residual volumes (GRVs; milliliters per day, number of GRVs >50% of the previous feeding volume, and number of GRVs >2 ml/kg), and abdominal distention. Infants underwent repeated measurement of lactase activity, GI permeability, fecal calprotectin concentration, and gastric emptying.
RESULTS: The number of GRVs >2 ml/kg tended to decrease with postnatal age (p = 0.06). Lactase activity and feeding volume in milliliters per kilogram per day prior to achieving full feedings were correlated (p = 0.007, β = 0.164). There was no correlation between feeding outcomes and GRV (ml/day), GRV >50%, GRV >2 ml/kg, small bowel, colonic, or whole bowel permeability, fecal calprotectin concentration, gastric emptying, or abdominal distention.
CONCLUSIONS: GRV is unreliable in predicting attainment of full gavage feeding. Lactase activity is related to feeding volume. However, other noninvasive GI tests utilized were not predictive. These data cast doubt upon the utility of GRV in guiding feeding therapy. Randomized trials of different GRV management protocols are needed.
Robert J Shulman; Ching-Nan Ou; E O'Brian Smith
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2010-06-30
Journal Detail:
Title:  Neonatology     Volume:  99     ISSN:  1661-7819     ISO Abbreviation:  Neonatology     Publication Date:  2011  
Date Detail:
Created Date:  2010-12-16     Completed Date:  2011-04-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  38-44     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 S. Karger AG, Basel.
Department of Pediatrics, Children's Nutrition Research Center, Houston, Tex 77030-2600, USA. rshulman @
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MeSH Terms
Eating / physiology*
Enteral Nutrition / methods*
Feces / chemistry
Feeding Behavior / physiology
Gastric Emptying
Gastrointestinal Contents*
Gestational Age
Infant Food
Infant, Newborn
Infant, Premature
Intubation, Gastrointestinal
Leukocyte L1 Antigen Complex / analysis
Patient Discharge
Prospective Studies
Grant Support
Reg. No./Substance:
0/Leukocyte L1 Antigen Complex; EC

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