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[Nycthemeral gastric secretion in children under parenteral feeding]
Insights
Gastric secretion in children on total parenteral feeding (TPF) shows a daily pattern, with lowest acid output at night and highest in the morning. This pattern persists regardless of TPF infusion, suggesting potential need for H2 antihistamines.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Physiology
Background:
- Understanding basal gastric secretion is crucial for managing pediatric patients requiring nutritional support.
- Total parenteral feeding (TPF) bypasses normal digestive processes, potentially altering gastric physiology.
- Nycthemeral (24-hour) patterns of gastric secretion are influenced by various factors, including feeding stimuli.
Purpose of the Study:
- To investigate the nycthemeral pattern of basal gastric secretion in children receiving total parenteral feeding (TPF).
- To determine if TPF infusion conditions affect the daily rhythm of gastric acid secretion.
- To explore potential factors influencing variations in basal gastric acid output during TPF.
Main Methods:
- Studied 11 children receiving continuous or cyclic total parenteral feeding (TPF).
- Monitored nycthemeral basal gastric secretion, assessing secretory flow over a 24-hour period.
- Analyzed secretory patterns in relation to TPF infusion schedules and composition.
Main Results:
- Basal gastric secretion exhibited a distinct nycthemeral rhythm, independent of TPF infusion methods.
- A nocturnal minimum and a diurnal morning maximum in secretory flow were observed.
- Infused amino acids, lipid emulsions, and TPF duration were suggested as factors influencing basal acid flow.
Conclusions:
- The study identified a consistent daily rhythm in gastric secretion in children on TPF, characterized by a morning peak.
- This morning secretory peak may cause functional impairment in some pediatric patients.
- Consideration of H2 antihistamines is suggested to manage potential issues arising from the morning acid secretion peak.
Abstract:
The nycthemeral basal gastric secretion was studied in 11 children under continuous or cyclic total parenteral feeding (TPF). The suppression of the prandial stimulation shows nycthemeral changes in the secretory flow with a nocturnal minimum and a diurnal morning maximum, independent of the TPF infusion-conditions. The role of the infused aminoacids and lipid emulsion, as well as the duration of TPF is suggested to explain the increase or decrease in the basal acid flow. The authors suggest that an H2 antihistaminic should be used if the morning secretory peak induces a significant functional impairment.