Small volumes of feed can trigger transient lower esophageal sphincter relaxation and gastroesophageal reflux in the right lateral position in infants

Michiel P van Wijk, Marc A Benninga, Geoffrey P Davidson, Ross Haslam, Taher I Omari

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)744-8, 748.e1
JournalJournal of Pediatrics
Volume156
Issue number5
DOIs
Publication statusPublished - May 2010

Cite this

van Wijk, Michiel P ; Benninga, Marc A ; Davidson, Geoffrey P ; Haslam, Ross ; Omari, Taher I. / Small volumes of feed can trigger transient lower esophageal sphincter relaxation and gastroesophageal reflux in the right lateral position in infants. In: Journal of Pediatrics. 2010 ; Vol. 156, No. 5. pp. 744-8, 748.e1.
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title = "Small volumes of feed can trigger transient lower esophageal sphincter relaxation and gastroesophageal reflux in the right lateral position in infants",
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 = "Electric Impedance, Enteral Nutrition, Esophageal Sphincter, Lower/physiopathology, Female, Gastroesophageal Reflux/physiopathology, Humans, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases/physiopathology, Male, Manometry, Muscle Relaxation, Posture",
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Small volumes of feed can trigger transient lower esophageal sphincter relaxation and gastroesophageal reflux in the right lateral position in infants. / van Wijk, Michiel P; Benninga, Marc A; Davidson, Geoffrey P; Haslam, Ross; Omari, Taher I.

In: Journal of Pediatrics, Vol. 156, No. 5, 05.2010, p. 744-8, 748.e1.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Small volumes of feed can trigger transient lower esophageal sphincter relaxation and gastroesophageal reflux in the right lateral position in infants

AU - van Wijk, Michiel P

AU - Benninga, Marc A

AU - Davidson, Geoffrey P

AU - Haslam, Ross

AU - Omari, Taher I

PY - 2010/5

Y1 - 2010/5

N2 - 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.

AB - 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.

KW - Electric Impedance

KW - Enteral Nutrition

KW - Esophageal Sphincter, Lower/physiopathology

KW - Female

KW - Gastroesophageal Reflux/physiopathology

KW - Humans

KW - Infant, Newborn

KW - Infant, Premature

KW - Infant, Premature, Diseases/physiopathology

KW - Male

KW - Manometry

KW - Muscle Relaxation

KW - Posture

U2 - 10.1016/j.jpeds.2009.11.006

DO - 10.1016/j.jpeds.2009.11.006

M3 - Article

VL - 156

SP - 744-8, 748.e1

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 5

ER -