Archives of Disease in Childhood, Vol 64, 1352-1355, Copyright © 1989 by Archives of Disease in Childhood.

PAPERS

Does mechanical ventilation precipitate gastro-oesophageal reflux during enteral feeding?

SJ Newell, ME Morgan, GM Durbin, IW Booth and AS McNeish
Institute of Child Health, University of Birmingham.

The influence of intermittent positive pressure ventilation on gastro- oesophageal reflux in preterm infants is not known. In many neonatal units, however, concern that ventilation may increase gastro- oesophageal reflux (and therefore aspiration) leads to avoidance of enteral feeding during ventilation. We have therefore performed a crossover study of gastrooesophageal reflux by monitoring lower oesophageal pH in a group of nine enterally fed, very low birthweight infants both during assisted ventilation and normal breathing. All infants had less reflux during intermittent positive pressure ventilation (mean (SEM) reflux index 2.3 (0.6%)) than during normal breathing (mean (SEM) reflux index 6.1 (1.1%)). Assisted ventilation was associated with a significant reduction in the gastro-oesophageal pressure gradient, an effect which may be related to the use of positive and end expiratory pressure during ventilation. These data show that fear of gastro-oesophageal reflux should not preclude the use of enteral feeding in preterm infants receiving ventilation.

This article has been cited by other articles:

				D. C Wilson, P. Cairns, H. L Halliday, M. Reid, G. McClure, and J. A Dodge Randomised controlled trial of an aggressive nutritional regimen in sick very low birthweight infants Arch. Dis. Child. Fetal Neonatal Ed., July 1, 1997; 77(1): 4F - 11. [Abstract] [Full Text]