TY - JOUR
T1 - Diagnosis and management of gastroesophageal reflux in preterm infants
AU - Eichenwald, Eric C.
AU - Yogman, Michael
AU - Lavin, Chairperson Arthur
AU - Lemmon, Keith M.
AU - Mattson, Gerri
AU - Rafferty, Jason Richard
AU - Wissow, Lawrence Sagin
N1 - Publisher Copyright:
Copyright © 2018 by the American Academy of Pediatrics. All rights reserved.
PY - 2018/7
Y1 - 2018/7
N2 - Gastroesophageal reflux (GER), generally defined as the passage of gastric contents into the esophagus, is an almost universal phenomenon in preterm infants. It is a common diagnosis in the NICU; however, there is large variation in its treatment across NICU sites. In this clinical report, the physiology, diagnosis, and symptomatology in preterm infants as well as currently used treatment strategies in the NICU are examined. Conservative measures to control reflux, such as left lateral body position, head elevation, and feeding regimen manipulation, have not been shown to reduce clinically assessed signs of GER in the preterm infant. In addition, preterm infants with clinically diagnosed GER are often treated with pharmacologic agents; however, a lack of evidence of efficacy together with emerging evidence of significant harm (particularly with gastric acid blockade) strongly suggest that these agents should be used sparingly, if at all, in preterm infants.
AB - Gastroesophageal reflux (GER), generally defined as the passage of gastric contents into the esophagus, is an almost universal phenomenon in preterm infants. It is a common diagnosis in the NICU; however, there is large variation in its treatment across NICU sites. In this clinical report, the physiology, diagnosis, and symptomatology in preterm infants as well as currently used treatment strategies in the NICU are examined. Conservative measures to control reflux, such as left lateral body position, head elevation, and feeding regimen manipulation, have not been shown to reduce clinically assessed signs of GER in the preterm infant. In addition, preterm infants with clinically diagnosed GER are often treated with pharmacologic agents; however, a lack of evidence of efficacy together with emerging evidence of significant harm (particularly with gastric acid blockade) strongly suggest that these agents should be used sparingly, if at all, in preterm infants.
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U2 - 10.1542/peds.2018-1061
DO - 10.1542/peds.2018-1061
M3 - Article
C2 - 29915158
AN - SCOPUS:85049595204
SN - 0031-4005
VL - 142
JO - Pediatrics
JF - Pediatrics
IS - 1
M1 - e20181061
ER -