Gastric Emptying and Small Intestinal Transit Time in Preterm Infants: a Scintigraphic Method

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Objectives:Practical methods to determine gastric emptying (GE) and small intestinal transit time in preterm infants are required. The aim of this study was to develop a scintigraphic method to determine GE and small intestinal transit time in preterm infants which produce minimal radiation exposure and physical disturbance in these infants.Methods:Ten premature infants were studied. Median (and range) for gestational age was 28.9 (26–33) weeks, postnatal age was 19 (6–37) days, birth weight was 1194 (687–2300) grams and feeding volume was 173 (6–205) mL/kg/day. Nine of the patients were on nasal continuous positive airway pressure; one patient was on mechanical ventilation. A dose (0.2–0.4 MBq) of 99mTc-DTPA (0.5 mL) was given at the end of a meal administered by naso-gastric tube. Static images were obtained with a mobile gamma camera during the next 9 to 12 hours. The radiation dose was at most 0.30 mSv. Regions of interest (ROIs) were drawn around the stomach and the cecum. Time-activity curves were generated. Gastric emptying half-time (T½GE) was calculated. Residual gastric activity after 1 hour (R (1h)) and after 2 hours (R (2h)) was determined. Orocecal transit time was defined as the time until significant increase in activity was detected in the cecal ROI.Results:Images showed gastric emptying in all cases. Median (range) half time was 1.0 (0.5–3.0) h. R (1h) was 37.5% (19% to 100%), R (2h) was 23% (6% to 61%). In one patient the tracer did not reach the cecum within 12 hours. In the remaining nine patients orocecal transit time was 3.1 (1.3–6.1) h.Conclusions:We present a new scintigraphic method to determine GE and orocecal transit time. It appears safe and practicable as a research tool in preterm infants.

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