Ultrasound assessment of gastric emptying time in preterm infants: A prospective observational study.
| Autor: | Beck CE, Witt L, Albrecht L, Winstroth AM, Lange M, Dennhardt N, Boethig D, Sümpelmann R |
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| Jazyk: | angličtina |
| Zdroj: | European journal of anaesthesiology [Eur J Anaesthesiol] 2019 Jun; Vol. 36 (6), pp. 406-410. |
| DOI: | 10.1097/EJA.0000000000001007 |
| Abstrakt: | Background: In paediatric anaesthesia, pre-operative fasting should be short to prevent discomfort, hunger, thirst and metabolic disorders. Current European guidelines recommend pre-operative fasting times of 4 h for breast milk and 6 h for formula milk in infants, whereas some national guidelines allow both until 4 h before anaesthesia. Objective: We evaluated the gastric emptying times of preterm infants after breast milk and formula milk, hypothesising that the mean gastric emptying time would be less than 4 h. Design: A prospective, observational, noninterventional cohort study. Setting: Neonatal ICU of a university hospital from August to September 2017. Patients: Twenty-two infants with a postmenstrual mean ± SD (range) age of 35 ± 2 (32 to 40) weeks were included. Based on their prescription plan, 10 infants received breast milk and 12 received formula milk with a total volume of 50 ± 16 (24 to 70) ml. Interventions: Gastric emptying was examined by sonographic measurements of the gastric antral area (GAA) before (FT0) and hourly after breast milk or formula milk feeding (FT1 to FT3). Main Outcome Measures: Estimated gastric emptying time after enteral feeding with breast milk and formula milk in preterm infants. Results: The GAA of the preterm infants initially increased and subsequently decreased after feeding. GAA correlated significantly with fasting time (r = -0.53, P < 0.0001). At FT3 [199 ± 16 (175 to 225) min], GAA was 0.57 (0.42 to 0.91) cm and showed no difference compared with FT0. Using a linear regression model, the calculated mean gastric emptying time was 218 min. Conclusion: The study shows that the mean gastric emptying time after enteral feeding with breast milk and formula milk is less than 4 h in preterm infants. These results support our current national fasting regimen of 4 h for any milk composition in infants before anaesthesia. Trial Registration: German registry of clinical studies (DRKS-ID: DRKS 00013893). |
| Databáze: | MEDLINE |
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