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Diagnosis and Management of Gastroesophageal Reflux in Preterm Infants

Eric C Eichenwald,

    Pediatrics
    |June 20, 2018
    PubMed

    Insights

    Gastroesophageal reflux (GER) is common in preterm infants. Current treatments, including conservative measures and medications, lack proven efficacy and may cause harm, suggesting cautious use in the NICU.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Gastroenterology

    Background:

    • Gastroesophageal reflux (GER) is prevalent in preterm infants, frequently diagnosed in Neonatal Intensive Care Units (NICUs).
    • Significant variability exists in GER treatment protocols across different NICU settings.

    Purpose of the Study:

    • To examine the physiology, diagnosis, and symptomatology of GER in preterm infants.
    • To review current treatment strategies for GER in the NICU.

    Main Methods:

    • Clinical report synthesizing existing data and clinical observations.
    • Analysis of conservative management techniques and pharmacologic interventions.

    Main Results:

    • Conservative measures like positioning and feeding adjustments show no significant reduction in GER signs.
    • Pharmacologic agents, especially gastric acid blockers, have limited efficacy and potential for harm in preterm infants.

    Conclusions:

    • Current pharmacologic treatments for GER in preterm infants lack robust evidence of benefit.
    • The risks associated with pharmacologic interventions suggest they should be used sparingly, if at all.

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