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Boccia, G.; Salvia, G.; Minella, R.; Rapagiolo, S.; Cascioli, C.; Ciccimarra, F.; Cucchiara, S.
Dept Pediatrics, University of Naples, Naples, Italy.
Survival of many preterm infants is related to the development of specific intestinal functions such as gastric motility and emptying. Furthermore, these subjects frequently present large gastric residual volumes due to gastroparesis. Therefore, knowledge of development of gastric electrical activity (GEA), which determines gastric motility, and of gastric emptying (GE) is of great interest for clinical purposes. Twelve preterm infants (aged: 25-28 weeks of gestational age) were longitudinally studied at weekly intervals by simultaneous recordings of GEA, through cutaneous electrogastrography (EGG), and of gastric emptying time through real time two dimensional ultrasound (US) of the gastric antrum (T/2, i.e. the time taken for antral cross sectional area to decrease by half and final GE time). Infants were receiving an appropriate infant formula with individual volumes according to the weight. The EGG variables were: % of normal GEA (3 cpm), % of tachygastria (> 4 cpm), fed-to-fasting ratio of EGG power. Data were compared with those detected in 10 full term infants and evaluated with analysis of variance for repeated measures (ANOVA), and Friedman's non parametric test for repeated measures. Results: % of both normal electrical rhythm and tachygastria in preterm infants were similar to those in full term infants (3 cpm; fasting: 70.2 ± 3.8, fed: 72.2 ± 5.0 - tachygastria: fasting: 24.6 ± 4.0, fed: 19.1 ± 3.5) by the 35 weeks of gestation (3 cpm: fasting: 66.7 ± 4.8, fed: 77.3 ± 6.0 - tachygastria: fasting: 33.3 ± 5.5, fed: 22.7 ± 4.5). The power ratio did not change at all the gestational ages. Ultrasound half-antral clearance (min.) showed a gradual decrease with increasing gestational age, that reached a statistical significance around 35 weeks of gestation (25-28 weeks: 82 min (range: 80-95); 35 weeks: 45 min (range: 35-75), p<0.01), whereas final GE time did not significantly change (25-28 weeks: 120 min (range: 100-175); 35 weeks: 110 min (range: 92-120), p<0.01). Conclusions: a clear pattern of maturation of gastric electrical activity and gastric emptying is seen in preterm infants; its knowledge provides a clue for planning enteral nutrition in these subjects. Advancing gestational age is accompanied by a change in the gastric emptying pattern which tends to become curvilinear with a rapid initial phase
© 1999 Lippincott Williams & Wilkins, Inc.
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