| Evaluation of potential factors predicting attainment of full gavage feedings in preterm infants. | |
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MedLine Citation:
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PMID: 20588069 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Robert J Shulman; Ching-Nan Ou; E O'Brian Smith |
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Publication Detail:
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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:
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Title: Neonatology Volume: 99 ISSN: 1661-7819 ISO Abbreviation: Neonatology Publication Date: 2011 |
Date Detail:
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Created Date: 2010-12-16 Completed Date: 2011-04-14 Revised Date: 2013-05-29 |
Medline Journal Info:
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Nlm Unique ID: 101286577 Medline TA: Neonatology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 38-44 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 S. Karger AG, Basel. |
Affiliation:
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Department of Pediatrics, Children's Nutrition Research Center, Houston, Tex 77030-2600, USA. rshulman @ bcm.tmc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Eating
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physiology* Enteral Nutrition / methods* Feces / chemistry Feeding Behavior / physiology Gastric Emptying Gastrointestinal Contents* Gestational Age Humans Infant Food Infant, Newborn Infant, Premature Intubation, Gastrointestinal Lactase Leukocyte L1 Antigen Complex / analysis Patient Discharge Prospective Studies |
| Grant Support | |
ID/Acronym/Agency:
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P30-DK56338/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Leukocyte L1 Antigen Complex; EC 3.2.1.108/Lactase |
| Comments/Corrections | |
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