Journal of perinatology : official journal of the California Perinatal Association · 2025
Gastroesophageal reflux during postpyloric versus gastric tube feeding in preterm infants with bronchopulmonary dysplasia.
СтатьяНаблюдательное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Jensen Erik A, Orians Carolyn M, Gibbs Kathleen, Ryan Matthew
Аннотация
BACKGROUND: Whether postpyloric feeding reduces gastroesophageal reflux (GER) in very preterm infants with bronchopulmonary dysplasia (BPD) is uncertain.
METHODS: Prospective observational study comparing GER profiles measured using 24-h esophageal pH-impedance monitoring in infants with BPD receiving clinically prescribed postpyloric (n = 21) or gastric (n = 24) tube feeding.
RESULTS: Participants (median gestational age 25.0 weeks, IQR 24.1-26.9) underwent testing at a median postmenstrual age of 46.6 weeks (IQR 42.7-52.4). The number of GER episodes recorded by impedance varied widely (median 27, range 1-195). Postpyloric versus gastric feeding was associated with fewer GER episodes (median, IQR: 16, 5-41 vs. 40, 19-60; p = 0.07) and less exposure of the proximal esophagus to reflux (median duration, IQR: 0.1 min, 0.005-0.6 vs. 0.77 min, 0.16-1.8; p = 0.045), but a higher proportion of acidic (pH < 4) GER episodes (median, IQR: 91%, 70-100 vs. 31%, 16-54; p < 0.001).
CONCLUSION: Postpyloric feeding may reduce total GER burden but increase the relative proportion of acidic GER in infants with BPD.
METHODS: Prospective observational study comparing GER profiles measured using 24-h esophageal pH-impedance monitoring in infants with BPD receiving clinically prescribed postpyloric (n = 21) or gastric (n = 24) tube feeding.
RESULTS: Participants (median gestational age 25.0 weeks, IQR 24.1-26.9) underwent testing at a median postmenstrual age of 46.6 weeks (IQR 42.7-52.4). The number of GER episodes recorded by impedance varied widely (median 27, range 1-195). Postpyloric versus gastric feeding was associated with fewer GER episodes (median, IQR: 16, 5-41 vs. 40, 19-60; p = 0.07) and less exposure of the proximal esophagus to reflux (median duration, IQR: 0.1 min, 0.005-0.6 vs. 0.77 min, 0.16-1.8; p = 0.045), but a higher proportion of acidic (pH < 4) GER episodes (median, IQR: 91%, 70-100 vs. 31%, 16-54; p < 0.001).
CONCLUSION: Postpyloric feeding may reduce total GER burden but increase the relative proportion of acidic GER in infants with BPD.