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[Gastric emptying in children. VII. Influence of body posture, using an oral hydration solution as the test meal]
1Departamento de Pediatria da Faculdade de Ciências Médicas da Universidade Estadual de Campinas.
Insights
Infant body position significantly impacts gastric emptying. Left lateral decubitus position retards emptying of oral rehydration solutions, suggesting careful positioning is crucial for pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Infant Physiology
Background:
- Gastric emptying is a critical factor in oral rehydration therapy for infants and children.
- Understanding how body position affects gastric emptying is essential for optimizing fluid absorption and treatment efficacy.
- Previous research has not fully elucidated the influence of decubitus position on gastric emptying in pediatric populations using standardized oral rehydration solutions.
Purpose of the Study:
- To investigate the effect of different decubitus positions on gastric emptying in infants and children.
- To determine if the position of a child influences the rate at which the World Health Organization (WHO) oral rehydration solution is emptied from the stomach.
Main Methods:
- A study involving 24 infants and children (1 day to 18 months) without gastrointestinal disturbances.
- Gastric emptying was assessed using phenolsulfonphthalein (PSP) dilution method over four consecutive days.
- Test meals consisted of WHO oral hydration solution administered via nasogastric tube, with residual volume measured in 'free', supine, right lateral, and left lateral decubitus positions.
Main Results:
- No significant differences in gastric emptying were observed in the 'free', right lateral, or supine positions.
- Gastric emptying was significantly retarded in the left lateral decubitus position compared to other positions.
- These findings were observed in healthy children, suggesting a positional effect independent of acute illness.
Conclusions:
- Child's decubitus position significantly influences gastric emptying of WHO oral rehydration solution.
- The left lateral decubitus position demonstrably slows gastric emptying.
- Clinicians should consider facilitating rapid gastric emptying by avoiding the left lateral decubitus position during rehydration therapy in pediatric patients.
Abstract:
Twenty four infants and children of both sexes with age ranging from 1 day to 18 months, and weighing between 2700 g and 10000 g, were studied. There were several reasons for admission; but during performance of the tests they were in complete recuperation of their illness and there was no evidence of gastrointestinal disturbs. Four gastric emptying studies were performed in every subject, in consecutive days, between 10 to 12 A.M. A nasogastric tube was used for injecting the test meals; these consisted of a dilute solution of phenolsulfonphthalein in a hydration oral solution recommended by W. H. O. Residual gastric volume was measured at the "free" position (without contention), and supine, right and left lateral decubitus, when the subjects were immobilized with a sheet. The test's sequence was aleatory. Our data allows us to conclude that the child's decubitus has an influence on gastric emptying when using the W.H.O. solution for oral hydration. Although no differences were observed, among the "free" position, right lateral and supine decubitus, the gastric emptying in the left lateral decubitus was significantly retarded. Even though this study has been carried among children without diarrhea or dehydration we still advise rapid gastric emptying position during rehydration in these little patients.