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Validation of Ultrasound Methods to Monitor Gastric Volume Changes in Preterm Infants

Perrella, Sharon L.*; Hepworth, Anna R.*; Simmer, Karen N.; Geddes, Donna T.*

Journal of Pediatric Gastroenterology and Nutrition: December 2013 - Volume 57 - Issue 6 - p 741–749
doi: 10.1097/MPG.0b013e3182a938d7
Original Articles: Hepatology and Nutrition

Objectives: The aim of this study was to validate 4 sonographic methods of estimating stomach volume for the purpose of monitoring changes in gastric volume over time and to describe the echogenic characteristics of milk feeds.

Methods: Twenty-four infants were monitored during a single intragastric tube feed, with 2 ultrasound images of the entire stomach and an image of the antral cross-sectional area (ACSA) before, during, and after the feed. Raw measurements, 3 stomach volume calculations, and ACSA were tested for intra- and interrater agreement. Calculated stomach volumes and ACSA were compared with delivered feed volumes, and characteristics of stomach image echogenicity graded at each time point.

Results: Spheroid calculation of stomach volume was the most reliable and valid measure of stomach volume. Fortified breast milk feeds were more echogenic than unfortified breast milk feeds. Residual stomach volumes (median 2.12 mL, range 0.59–9.27 mL) were identified in 18 of 24 infants.

Conclusions: Direct ultrasound stomach measurement (spheroid) will provide a useful research tool and a potential clinical tool for assessing gastric emptying and feeding intolerance in preterm infants.

*School of Chemistry and Biochemistry

Centre for Neonatal Research and Education, School of Paediatrics and Child Health, University of Western Australia, Crawley, Western Australia, Australia.

Address correspondence and reprint requests to Sharon L. Perrella, M310, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia (e-mail:

Received 22 April, 2013

Accepted 9 August, 2013

S.P. presently receives a scholarship from the Women & Infants Research Foundation and Medela AG. D.T.G. presently receives an unrestricted research grant from Medela AG.

The authors report no conflicts of interest.

© 2013 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,