Metoclopramide, thickened feedings, and positioning for gastro-oesophageal reflux in children under two years.

摘要: Background Gastro-esophageal reflux (GER) is the refluxing of gastric contents into esophagus. Fifty per cent all infants 0 to 3 months regurgitate at least once a day. This drops 5% are 10 12 old. Three parents month old view this as problem. Objectives To investigate effectiveness thickened feeds, positioning, and metoclopramide compared placebo in improving outcome GER developmentally normal aged one two years. Search strategy Trials were identified by searching Cochrane Central Register Controlled (The Library 2003), MEDLINE (January 1966 23 January EMBASE 1985 27 reference lists articles. Searches databases updated April 2009. Selection criteria Randomised studies (parallel or cross over) which evaluated positional alternations for treatment children between age years who normal. Data collection analysis All three reviewers independently assessed trial quality extracted data. Study authors contacted additional information. Adverse effects information was collected from trials. Main results Twenty trials involving 771 met inclusion criteria: eight dealt with five seven metoclopramide. Few comparisons could be made, so summary measures often made studies. Thickened feeds reduce regurgitation severity score (standardized mean difference (SMD) -0.94;95% confidence interval -1.35 -0.52), well frequency emesis (SMD -0.91; -1.22 -0.61). The index not reduced (weighted (WMD) 0.48%; 95% -3.27 4.23). positioning utilized esophageal pH monitoring their measure. Elevating head crib treating supine position justifiable. used variety outcomes. Compared placebo, appears daily symptoms ( SMD -0.73; -1.16 -0.30), (WMD -2.80%; -5.58 -0.01). It does increase side effects. Authors' conclusions helpful reducing GER. have any effect. Metoclopramide may some benefit comparison symptomatic GER, but that must weighed against possible .