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The relationship between somatic growth and in vivo esophageal segmental and sphincteric growth in human neonates
Alankar Gupta1, Sudarshan Rao Jadcherla
1Section of Neonatology, Columbus Children's Hospital, Columbus, OH 43205, USA.
Insights
Esophageal segment lengths in neonates strongly correlate with postmenstrual age and somatic growth. This finding is crucial for accurate placement of esophageal probes and gavage tubes in infants.
Area of Science:
- Neonatal physiology
- Gastroenterology
- Pediatric medical device development
Background:
- Accurate measurement of aerodigestive tract length is vital for correct placement of esophageal probes and gavage tubes.
- The relationship between esophageal segment lengths (esophageal body, upper esophageal sphincter [UES], and lower esophageal sphincter [LES]) and somatic growth in neonates is not well understood.
Purpose of the Study:
- To evaluate the relationship between segmental esophageal lengths and somatic growth parameters in neonates.
- To determine the relationship between segmental esophageal lengths and gestational age (GA) and postmenstrual age (PMA) in preterm and full-term infants.
Main Methods:
- Esophageal manometry studies were conducted on 75 infants (30-60 weeks PMA).
- Nares-to-LES, nares-to-UES, esophageal body length, and UES/LES lengths were measured and correlated with somatic growth parameters.
- Longitudinal studies in 26 subjects assessed growth rates of esophageal segments using analysis of variance and linear regression.
Main Results:
- Significant correlations (P < 0.001) were found between PMA, physical growth, and the growth of nares-to-LES (R = 0.8), esophageal body length (R = 0.6), and nares-to-UES (R = 0.4).
- Nares-to-LES length demonstrated a growth rate of 0.25 cm/week PMA between 33.0 and 36.0 weeks of age.
Conclusions:
- In vivo measurements of neonatal esophageal segmental lengths show a strong correlation with somatic growth parameters and postmenstrual age.
- This research suggests practical applications for improving the use of esophageal probes and catheters in neonates.
Background:
Measurement of aerodigestive tract length is an important determinant for accurate placement of esophageal probes and gavage tubes at the desired location. The relationship of esophageal body, upper esophageal sphincter (UES) and lower esophageal sphincter (LES) lengths with somatic growth in neonates is not well understood.
Objectives:
Our objectives were to (1) evaluate a relationship between segmental esophageal lengths and somatic growth parameters and (2) ascertain the relationship between segmental esophageal lengths and gestational age (GA) and postmenstrual age (PMA) in preterm and full-term born human neonates.
Design/Methods:
One hundred esophageal manometry studies were performed in 75 infants (30-60 weeks PMA) and the high-pressure zones of LES and UES identified. The distance from nares to LES and from nares to UES, esophageal body length, length of UES and LES derived from the manometry studies were correlated with somatic growth parameters. Growth rate of different esophageal segments was also determined in 26 subjects that underwent longitudinal studies. Analysis of variance and linear regression analysis were performed.
Results:
Seventy-five neonates of 23.0-40.6 weeks gestational age (0.6-4.4 kg) were studied at 29.1-58.6 weeks PMA (1.0-6.4 kg). Significant correlation (P < 0.001) of PMA and physical growth parameters with the growth of nares-LES (R = 0.8), esophageal body length (R = 0.6) and nares-UES (R = 0.4) were noted. Nares-to-LES length increased at a rate of 0.25 cm/wk PMA during 33.0-36.0 weeks of age.
Conclusions:
In vivo esophageal segmental lengths correlated strongly with somatic growth parameters and PMA in neonates. We speculate that this approach has many practical applications with the use of esophageal probes and catheters.
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