Gastric emptying (GE) is often reported to be slower and more irregular in premature neonates than in older children and adults. The aim of this study was to investigate the impact of age and other covariates on the rate of GE. The effect of age on the mean gastric residence times (MGRT) of liquid and solid food was assessed by analyzing 49 published studies of 1457 individuals, aged from 28 weeks gestation to adults. The data were modeled using the nonlinear mixed-effects approach within NONMEM version 7.2 (Icon, Dublin, Ireland), with evaluation of postnatal age, gestational age and meal type as covariates. A double Weibull function was selected as a suitable model since it could account for the typical biphasic nature of GE. Age was not a significant covariate for GE but meal type was. Aqueous solutions were associated with the faster emptying time (mean imulated gastric residence time of 45 min) and solid food as associated with the slowest (98 min). These findings challenge the essertion that GE is different in neonates, as compared with older children and adults due to age, and they reinforce the significance of food type in modulating GE.
Author(s): Jennifer Bonner, Pavan Vajjah, Khaled Abduljalil, Masoud Jamei, Amin Rostami-Hodjegan, Geoffrey Tucker, Trevor Johnson