[Pandrial gastroesophageal reflux in healthy preterm infants]

The neutralization of gastric content during feeding and in the immediate postpandrial period, has determined that until recently time these periods were excluded in the studies of the gastroesophageal reflux disease (GERD) that were made with pH-metría. The aim of this study was to characterize the events of reflux during feeding with pH and impedance,and later to compare them with which it happens in fasting periods.

We recording pH and Impedance in 21 preterms neonates without associated pathology, except the prematurity, during 8 periods of feeding-fasting (1 hour of feeding and 2 hours of rest), replacing the nasogastric tube by a catheter of feeding + impedance, previous informed consent.

The average of reflux during the meals per hour was of 3.36 h +/- 1.23 h, whereas in fasting periods was 1.02 h was of 2.65 h +/- (p = 0.068). The number of acid reflux per hour during the fasting was higher [1, 05 (0.34-1.23) h] than in feeding periods [0, 20 (0-1.12) h] (p = 0,044). The number of weakly acid reflux per hour was significantly higher in feeding periods [2, 71 (2.03-3.30) h] than in fasting periods [1, 35 (1.13-1.97) h] (p = 0, 05). The acid exposure during the meals was of 2, 35% whereas in fasting periods was of 7, 23%.

The incorporation of the Impedance within the battery of tests for the diagnosis of the gastroesophageal reflux in the pediatric population, at the moment allows us to know the pattern behavior of esophagus during the meals: feeding periods were associated with a greater number of reflux per hour, most of which weakly acidic; the acid exposure was significantly greater during fasting periods.