Gastric Volume Changes in Preterm Neonates during Intermittent and Continuous Feeding-GRV and Feeding Mode in Preterm...

Area of Science:

• Neonatology
• Pediatric Gastroenterology
• Medical Imaging

Background:

• Evaluating gastric volume changes in very premature neonates (VPN) is crucial for optimizing feeding strategies.
• Gastric residual volume (GRV) assessment methods need refinement for accuracy in this population.
• Comparing intermittent milk feeds (IMF) and continuous milk feeds (CMF) is essential for understanding neonatal digestion.

Purpose of the Study:

• To assess gastric volume changes during IMF and CMF in very premature neonates.
• To measure gastric residual volume (GRV) using antral cross-sectional area (ACSA) via ultrasound.
• To compare GRV and gastric emptying patterns between IMF and CMF.

Main Methods:

• A randomized prospective clinical trial with a crossover design was employed.
• Thirty-one preterm neonates (gestational age < 30 weeks) participated.
• Gastric volume was assessed using ultrasound (U/S) to measure antral cross-sectional area (ACSA) at 7 time points over 2 hours for both IMF and CMF.

Main Results:

• Significant differences in gastric volume changes were observed between IMF and CMF.
• Median GRV at 120 minutes was 3% for IMF versus 50% for CMF.
• Mean gastric emptying time was significantly shorter with IMF (p = 0.0032), with no feeding intolerance reported.

Conclusions:

• Gastric volume changes and emptying time in very premature neonates are dependent on the feeding method (IMF vs. CMF).
• Ultrasound-based ACSA measurements provide a valuable method for assessing gastric volume.
• Continuous milk feeds (CMF) resulted in higher GRV but were well-tolerated up to 80% in this cohort.