Gastroesophageal reflux during postpyloric versus gastric tube feeding in preterm infants with bronchopulmonary dysplasia.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-04-10 DOI:10.1038/s41372-025-02301-5

Erik A Jensen, Carolyn M Orians, Kathleen Gibbs, Matthew Ryan

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引用次数: 0

Abstract

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.

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支气管肺发育不良早产儿幽门后与胃管喂养期间胃食管反流的比较

背景：幽门后喂养是否能减少极早产儿支气管肺发育不良（BPD）的胃食管反流（GER）尚不确定。方法：前瞻性观察研究比较接受临床规定的幽门后（n = 21）或胃后（n = 24）管饲的BPD婴儿24小时食管ph -阻抗监测的GER特征。结果：参与者（中位胎龄25.0周，IQR 24.1-26.9）在中位经后年龄46.6周（IQR 42.7-52.4）时接受了测试。阻抗记录的GER发作次数差异很大（中位数27，范围1-195）。幽门后喂养与胃喂养相比，GER发作次数较少(中位数，IQR: 16,5 -41比40,19 -60；p = 0.07)和较少暴露于食管近端反流(中位持续时间，IQR: 0.1 min, 0.005-0.6 vs. 0.77 min, 0.16-1.8；p = 0.045)，但酸性（pH）比例较高。结论：幽门后喂养可降低BPD婴儿的GER总负担，但会增加酸性GER的相对比例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.