Effect of Body Position Changes on Postprandial Gastroesophageal Reflux and Gastric Emptying in the Healthy Premature Neonate
Received 16 January 2007; received in revised form 13 April 2007; accepted 7 June 2007. published online 08 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)
The Effect of Body Positioning on Gastroesophageal Reflux in Premature Infants: Evaluation by Combined Impedance and pH Monitoring
, 10 October 2007
Luigi Corvaglia, Raffaella Rotatori, Marianna Ferlini, Arianna Aceti, Gina Ancora, Giacomo Faldella
The Journal of Pediatrics
December 2007 (Vol. 151, Issue 6, Pages 591-596.e1) Abstract |
Full Text |
Full-Text PDF (288 KB)
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.
aCentre for Paediatric and Adolescent Gastroenterology, Women’s and Children’s Hospital, Children, Youth and Women’s Health Services, North Adelaide, Australia
bNeonatal Unit, Women’s and Children’s Hospital, Children, Youth and Women’s Health Services, North Adelaide, Australia
cAdelaide University Department of Paediatrics, Women’s and Children’s Hospital, Children, Youth and Women’s Health Services, North Adelaide, Australia
dDepartment of Paediatric Gastroenterology and Nutrition, Emma Children’s Hospital/Academic Medical Centre, Amsterdam, The Netherlands
eDepartment of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia.
Reprint requests: Michiel van Wijk, Academic Medical Centre, Endoscopy Department, Room C2-312, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
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.
ABSTRACT