The Effect of Body Positioning on Gastroesophageal Reflux in Premature Infants: Evaluation by Combined Impedance and pH Monitoring
Received 1 February 2007; received in revised form 27 April 2007; accepted 6 June 2007. published online 10 October 2007.
Refers to article:
Gastroesophageal Reflux in Preterm Infants: Is Positioning the Answer?
Richard J. Martin, Juliann M. Di Fiore, Anna Maria Hibbs
The Journal of Pediatrics
December 2007 (Vol. 151, Issue 6, Pages 560-561) Full Text |
Full-Text PDF (64 KB)
Effect of Body Position Changes on Postprandial Gastroesophageal Reflux and Gastric Emptying in the Healthy Premature Neonate
, 08 October 2007
Michiel P. van Wijk, Marc A. Benninga, John Dent, Ros Lontis, Louise Goodchild, Lisa M. McCall, Ross Haslam, Geoffrey P. Davidson, Taher Omari
The Journal of Pediatrics
December 2007 (Vol. 151, Issue 6, Pages 585-590.e2) Abstract |
Full Text |
Full-Text PDF (497 KB)
Objective
To evaluate the pattern of acid and nonacid gastroesophageal reflux (GER) in different body positions in preterm infants with reflux symptoms by a combined multichannel intraluminal impedance (MII)–pH monitoring, which identifies both acid and nonacid GER.
Study design
Premature infants with frequent regurgitation and postprandial desaturation (n = 22) underwent a 24-hour recording of MII-pH. In a within-subjects design, reflux indexes were analyzed with the infants in 4 different positions: supine (S), prone (P), on the right side (RS), and on the left side (LS).
Results
All infants were analyzed for 20 hours. The mean number of recorded GER episodes was 109.7. The mean esophageal exposure to acid and nonacid GER was lower in positions P (4.4% and 0.3%, respectively) and LS (7.5% and 0.7%, respectively) than in positions RS (21.4% and 1.2%, respectively) and S (17.6% and 1.3%, respectively). The number of postprandial nonacid GER episodes decreased but the number of acid GER episodes increased over time. The LS position showed the lowest esophageal acid exposure (0.8%) in the early postprandial period, and the P position showed the lowest esophageal acid exposure (5.1%) in the late postprandial period.
Conclusion
Placing premature infants in the prone or left lateral position in the postprandial period is a simple intervention to limit GER.
ABSTRACT