PubMed · 1499459
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S F Phillips, M Camilleri. 1992. Antroduodenal manometry.. https://doi.org/10.1007/bf01296580
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Previous studies have shown that duodenal motility patterns differ in preterm and term infants, but antral motor activities were not compared. Using a validated, low-compliance, continuous-perfusion, neonatal manometric system, antral and duodenal motility was studied in 19 preterm and nine term infants. Antral motility consisted of isolated single contractions and clustered phasic contractions in term and preterm infants. There were no differences in the occurrence or amplitude of antral activity between the two groups of infants. Thus, there was no change of antral motor activity with advancing gestational age. As has been shown in other previous studies, however, intestinal motor characteristics were more immature in preterm than term infants; clustered phasic contractions occurred more frequently (P less than 0.02) and were of shorter duration (P less than 0.02) and lower amplitude (P less than 0.005). Duodenal clusters were significantly less common, while their amplitudes were significantly increased with increasing gestational age. The proportion of antral clusters that were temporally associated with duodenal activity was significantly lower in preterm infants than in term infants (P less than 0.001). Moreover, the degree of association of antral and duodenal activity increased significantly with gestational age (r = 0.5, P = 0.006). These data show that fasting antral motor activity per se is comparable in preterm and term infants; they also suggest that the temporal association of antral and duodenal activity develops in association with progressive changes in duodenal motor activity in the preterm infant.
To assess the usefulness of duodenojejunal manometry in predicting when neonates will tolerate enteral feeding, small intestinal manometry was performed in 48 preterm infants. Characteristics of motor activity during fasting and feeding differed in 40 infants who were identified to be tolerant and 8 who were intolerant of feeding. Among infants who were feeding intolerant, motor quiescence was less pronounced and clustered motor activity more prominent than it was in infants who were able to tolerate feedings (P < 0.005). Those infants who tolerated feedings changed their pattern of motor activity in response to feeding (P < 0.01), and infants who did not tolerate feedings had no "fed response." Infants who were initially feeding intolerant became tolerant of feedings coincident with the appearance of motor activity that was similar to that of infants who were initially tolerant to food. The sensitivity of manometry to predict feeding intolerance was 1.0, and its specificity was 0.13.