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Transpyloric feeding in gastroesophageal-reflux-associated apnea in premature infants

Sudipta Misra1, Kamlesh Macwan, Viola Albert

  • 1Division of Pediatric Gastroenterology, Department of Pediatrics, University of Illinois College of Medicine at Peoria, Children's Hospital of Illinois at OSF St. Francis Hospital, Peoria, Illinois, USA. smisra@pol.net

Acta Paediatrica (Oslo, Norway : 1992)
|September 14, 2007
PubMed

Insights

Transpyloric feeding may help diagnose and manage gastroesophageal reflux-associated apnea in premature infants. This intervention showed significant improvement in most infants studied, aiding in treatment decisions.

Area of Science:

  • Neonatology
  • Pediatric Gastroenterology

Background:

  • Gastroesophageal reflux is a suspected cause of apnea of prematurity, but its role is debated.
  • Transpyloric feeding is hypothesized to reduce reflux and aspiration.

Purpose of the Study:

  • To investigate the association between transpyloric feeding and a decrease in reflux-related apnea in premature infants.
  • To evaluate the diagnostic and therapeutic utility of transpyloric feeding for apnea of prematurity.

Main Methods:

  • Retrospective chart review of 41 premature infants on transpyloric feeds.
  • Analysis of 15 infants with apnea of prematurity and gastroesophageal reflux.
  • Comparison of apnea frequency before and after initiating transpyloric feeds using t-statistics.

Main Results:

  • Twelve out of 15 infants (80%) demonstrated a significant reduction in apnea (p <.005) with transpyloric feeds.
  • Non-responders were identified within 48 hours.
  • Two responders proceeded to antireflux surgery, while nine were discharged without further intervention.

Conclusions:

  • Transpyloric feeding appears beneficial for diagnosing and managing gastroesophageal reflux-associated apnea in select premature infants.
  • This approach can guide further treatment, including surgery or discharge.
Abstract

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