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Ultrasonic assessment of gastric emptying in the preterm infant
S J Newell1, S Chapman, I W Booth
1Regional Neonatal Intensive Care Unit, Birmingham Maternity Hospital.
Insights
Ultrasonic measurement of gastric antral clearance offers a new, valid technique for studying gastric emptying in preterm infants. This method proved reliable and reproducible in low birth-weight infants.
Area of Science:
- Neonatal physiology
- Gastroenterology
- Medical imaging
Background:
- Assessing gastric emptying in preterm infants is challenging due to a lack of validated techniques.
- Previous methods have limitations in accuracy and applicability to this vulnerable population.
Purpose of the Study:
- To evaluate the efficacy and reliability of serial ultrasonic measurement of antral cross-sectional area (ACSA) for assessing gastric antral clearance in preterm infants.
- To establish ACSA as a valid surrogate for intragastric volume and assess measurement reproducibility.
Main Methods:
- Utilized serial ultrasound to measure antral cross-sectional area (ACSA) in low birth-weight infants.
- Correlated ACSA measurements with intragastric volume and assessed reproducibility.
- Observed the pattern and rate of gastric antral clearance post-feeding.
Main Results:
- The technique was successful in 15 of 17 infants, with feed volumes ranging from 8-31 ml/kg.
- ACSA demonstrated a strong correlation with intragastric volume (r = 0.96).
- Measurements were reproducible (mean coefficient of variation 7.7%), with half gastric antral clearance times ranging from 20-63 minutes.
Conclusions:
- Ultrasonic measurement of gastric antral clearance is a novel, valid, and reproducible technique for studying gastric emptying in preterm infants.
- This non-invasive method provides a reliable way to assess gastric function in this population.
Abstract:
The study of gastric emptying in the preterm infant has been hampered by the absence of a suitable, valid technique. We have evaluated gastric antral clearance using serial ultrasonic measurement of the antral cross sectional area (ACSA). The study was easy to perform, providing successful results in 15 of 17 low birth-weight infants, with feed volumes of 8-31 ml/kg. ACSA was closely related to intragastric volume (mean (range) r = 0.96 (0.89-0.99)). Measurements were reproducible: mean (SE) coefficient of variation was 7.7% (1.1). Gastric antral clearance was observed as a fall in ACSA that began shortly after completion of the feed and returned to prefeed values at a variable rate. The pattern of gastric antral transit was entirely consistent with recognised patterns of gastric emptying and half gastric antral clearance times ranged from 20-63 minutes. Ultrasonic measurement of gastric antral clearance is a new technique allowing the study of gastric emptying in the preterm infant.