Effect of Routine Gastric Residual Aspiration on the Preterm Infant Fecal Microbiome

Area of Science:

• Neonatal intensive care
• Microbiome research
• Gastrointestinal health

Background:

• Enteral feeding tubes are crucial in neonatal intensive care units (NICUs) for assessing feeding tolerance.
• Preprandial gastric residual aspiration is a common practice for this assessment.
• The impact of this practice on the preterm infant gut microbiome and gastrointestinal inflammation is not fully understood.

Purpose of the Study:

• To evaluate the effect of gastric residual aspiration on the fecal microbiome of preterm infants.
• To assess the impact of gastric residual aspiration on gastrointestinal inflammation in preterm infants.

Main Methods:

• A secondary analysis of 51 very low birth weight (VLBW) infants from a randomized controlled trial.
• Microbiome analysis using 16S rRNA gene sequencing on stool samples from 30 infants.
• Intestinal inflammation assessment via cytokine multiplex panels on stool samples from 21 infants.

Main Results:

• No significant differences in microbial communities or intestinal inflammation were observed between infants with and without routine gastric residual aspiration.
• Gene expression analysis suggested a potentially more commensal intestinal microbiome in infants not undergoing aspiration.
• Statistically significant differences in several taxa were identified, warranting further investigation.

Conclusions:

• Omission of routine gastric residual aspiration is not associated with intestinal dysbiosis or inflammation in VLBW infants.
• Current evidence suggests that routine monitoring of preprandial gastric residuals may be unnecessary.
• Further research is needed, but findings support discontinuing routine gastric residual monitoring.