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Investigation and management of gastro-oesophageal reflux in United Kingdom neonatal intensive care units.

Investigation and management of gastro-oesophageal reflux in United Kingdom neonatal intensive care units.
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Rossor T, Andradi G, Bhat R, Greenough A,


Rossor T, Andradi G, Bhat R, Greenough A, (click to view)

Rossor T, Andradi G, Bhat R, Greenough A,

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Acta paediatrica (Oslo, Norway : 1992) 2017 09 13() doi 10.1111/apa.14073
Abstract
AIM
In 2004 wide variation in the investigation and management of gastro-oesophageal reflux (GOR) of infants on UK major neonatal units was demonstrated. Our aim was to re-survey neonatal practitioners to determine current practice and whether it was now evidence based.

METHODS
A questionnaire was sent to all 207 UK neonatal units.

RESULTS
Responses were obtained from 84% of units. The most frequent "investigation" was a trial of therapy (83% of units); pH studies were used in 38%, upper GI contrast studies in 19% and multichannel intraluminal impedance (MII)/pH studies in 5%. Only six units suggested a threshold for an abnormal pH study and two units for an abnormal MII study. Infants were commenced on anti-reflux medication without investigation always in 32% of units, often in 29%, occasionally in 19% and only never in 1%. Gaviscon was used as first line treatment in 60% of units, other medications included ranitidine in 53%, thickening agents in 27%, proton pump inhibitors in 23%, domperidone in 22% and erythromycin in 6%.

CONCLUSION
There remains a wide variation in diagnostic and treatment strategies for infants with suspected GOR on neonatal intensive care units, emphasizing the need for randomised trials to determine appropriate GOR management. This article is protected by copyright. All rights reserved.

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