Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/59764
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Type: Journal article
Title: Small volumes of feed can trigger transient lower esophageal sphincter relaxation and gastroesophageal reflux in the right lateral position in infants
Author: van Wijk, M.
Benninga, M.
Davidson, G.
Haslam, R.
Omari, T.
Citation: Journal of Pediatrics, 2010; 156(5):744-759
Publisher: Mosby Inc
Issue Date: 2010
ISSN: 0022-3476
1097-6833
Statement of
Responsibility: 
Michiel P. van Wijk, Marc A. Benninga, Geoffrey P. Davidson, Ross Haslam, and Taher I. Omari
Abstract: 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.
Keywords: Esophageal Sphincter, Lower; Humans; Gastroesophageal Reflux; Infant, Premature, Diseases; Enteral Nutrition; Manometry; Electric Impedance; Posture; Muscle Relaxation; Infant, Newborn; Infant, Premature; Female; Male
Rights: Copyright © 2010 Mosby, Inc. All rights reserved.
RMID: 0020100169
DOI: 10.1016/j.jpeds.2009.11.006
Appears in Collections:Paediatrics publications

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