Document Detail

Small volumes of feed can trigger transient lower esophageal sphincter relaxation and gastroesophageal reflux in the right lateral position in infants.
MedLine Citation:
PMID:  20097362     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the threshold amount of constantly infused feed needed to trigger lower esophageal sphincter relaxation (TLESR) in the right lateral position (RLP) and left lateral position (LLP). STUDY DESIGN: Eight healthy infants (3 male; gestational age: 32.9 +/- 2.4 weeks; corrected age: 36.1 +/- 1.3 weeks) were studied using an esophageal impedance-manometry catheter incorporating an intragastric infusion port. After tube placement, infants were randomly positioned in RLP or LLP. They were then tube-fed their normal feed (62.5 [40 to 75] mL) at an infusion rate of 160 mL/h. Recordings were made during the feed and 15 minutes thereafter. The study was repeated with the infant in the opposite position. RESULTS: More TLESRs were triggered in the RLP compared with LLP (4.0 [3.0 to 6.0] vs 2.5 [1.0 to 3.0], P = .027). First TLESR occurred at a significantly lower infused volume in RLP compared with LLP (10.6 +/- 9.4 vs 21.0 +/- 4.9 mL, P = .006). The percentage of feed infused at time of first TLESR was significantly lower in RLP compared with LLP (17.6% +/- 15.5% vs 35.4% +/- 8.02%, P = .005). CONCLUSIONS: In the RLP, TLESRs and gastroesophageal reflux are triggered at volumes unlikely to induce gastric distension.
Michiel P van Wijk; Marc A Benninga; Geoffrey P Davidson; Ross Haslam; Taher I Omari
Publication Detail:
Type:  Journal Article     Date:  2010-01-25
Journal Detail:
Title:  The Journal of pediatrics     Volume:  156     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-13     Completed Date:  2010-05-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  744-8, 748.e1     Citation Subset:  AIM; IM    
Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Electric Impedance
Enteral Nutrition*
Esophageal Sphincter, Lower / physiopathology*
Gastroesophageal Reflux / physiopathology*
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / physiopathology*
Muscle Relaxation

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