CLINICAL EFFICACY OF GASTRIC FEEDING WITH ANTIREFLUX MIXTURE IN PREMATURE INFANTS ON MECHANICAL VENTILATION
Abstract
Introduction. Gastroesophageal refl ux is a common pathological condition in critically ill premature infants. The aim of the study was to analyze the incidence of gastroesophageal refl ux (GER) in premature infants and to evaluate the eff ectiveness of gastric feeding with antirefl ux mixture in children on artifi cial ventilation in the presence of GER. Materials and methods. A retrospective study was conducted on the basis of the Irkutsk Municipal Pediatric Clinical Hospital (Irkutsk) in the period from 2018 to 2020, which included the medical histories of 73 premature infants. In the course of the study, the frequency of GER, the frequency of use of antirefl ux drugs, changes in body weight during the period of stay in intensive care, the duration of ventilation, the duration of stay in intensive care and changes in laboratory parameters at the time of admission and 10 days after the start of intensive care were evaluated. Results and discussion. A retrospective analysis showed that 69.8% of the total number of children in the medical history had any records of manifestations of gastroesophageal refl ux. When clinical manifestations of GER occurred, the frequency of transfer to an antirefl ux mixture was in 100% of cases, of which 52.4% received medication (motilium, omeprazole) during hospitalization in intensive care, and 19.6% continued to receive it after transfer to the department. Among those who received antirefl ux mixtures, GER was diagnosed in only 47% of patients. Among all newborns who received the drugs, 62.7% of patients received motilium and 35.2% omeprazole. With the ineff ectiveness of conservative antirefl ux therapy, surgical fundoplication was performed in 17.6% of patients. Conclusion. Conservative antirefl ux therapy for gastric feeding in premature infants with low and very low body weight, with pneumonia, on artifi cial lung ventilation does not provide suffi cient eff ectiveness of child nutrition.
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