CHANGES IN GASTRIC-EMPTYING IN EARLY POSTNATAL LIFE

Objective: To study the pattern of gastric emptying in very premature infants and to determine whether there are changes with postnatal age and the ability to tolerate feedings, Methods: Sequential ultrasound m easurements of the gastric antral cross-sectional area were obtained i n 32 infants (mean gestational age, 26 +/- 1 weeks) before and after f eeding for 2 hours, Studies were carried out after initiation of feedi ngs, when full feedings were received, and at 32 weeks, Infants classi fied as feeding intolerant (n = 9) were also studied when feedings wer e restarted. Gastric emptying was assessed by the time taken for antra l cross-sectional area to reach maximal value and to decrease to half the maximal increment (half-antral clearance), Results: Delayed antral distention was observed at the time of the initial study in both feed ing-tolerant (8 of 23) and feeding-intolerant (8 of 9) infants; howeve r, there were significant differences in times for maximal antral dist ention (p < 0.002) and half-antral clearance (p < 0.006) between the f eeding-tolerant and feeding-intolerant infants, By the time of full fe edings, the feeding-intolerant infants showed immediate gastric emptyi ng but still had a longer half-antral clearance time (p < 0.01). By 32 weeks, all infants had immediate antral distention and a more mature curvilinear pattern of gastric emptying, Conclusions: Knowledge of the se different patterns of gastric emptying in very premature infants ma y lead to the development of more rational feeding strategies.