{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T08:25:22Z","timestamp":1765959922858,"version":"3.40.4"},"reference-count":16,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neonatology"],"published-print":{"date-parts":[[2017]]},"abstract":"<b><i>Background:<\/i><\/b> Meconium retention is associated with feeding intolerance. Trials using glycerol and Gastrografin to expedite the evacuation of meconium have failed to generate clinically valid results for efficacy and safety. <b><i>Objective:<\/i><\/b> We assessed the feasibility of aggressive meconium evacuation with saline rectal washout (RW) in very-low-birth-weight infants to reduce the time it took them to reach full enteral feeds. <b><i>Methods:<\/i><\/b> We conducted an open-label, pilot, randomized controlled trial (RCT) (birth weight stratified, i.e., to 750-999 g and 1,000-1,500 g) of early aggressive meconium evacuation with twice-daily normal saline RW compared to conventional management with glycerin suppositories (GS), until full enteral feeds (110 mL\/kg\/day) were reached. Primary outcome was time to reach full enteral feeds. Safety, process, and secondary efficacy outcomes were also evaluated. <b><i>Results:<\/i><\/b> Sixty-one infants were randomized, 28 to RW and 33 to GS. The process and feasibility outcomes were met. RW was found to be safe; none of the RW-randomized infants developed necrotizing enterocolitis (\u2265 stage II) or complications secondary to RW. Evidence of efficacy was supported: in the 750-999 g stratum (<i>n<\/i> = 15), the median time to full enteral feeds was shorter with RW (11.0 days, 95% CI: 10.4-11.6) than with GS (15.6 days, 95% CI: 13.0-18.2) by a reduction of 4.6 days (<i>p<\/i> = 0.027). In the 1,000-1,500 g stratum (<i>n<\/i> = 46), there was no evidence of benefit: RW 10.2 days (95% CI 8.3-12.1) and GS 10.1 days (95% CI 9.3-10.9, <i>p<\/i> = 0.304). <b><i>Conclusion:<\/i><\/b> Our protocol was feasible and an adequately powered RCT is required to confirm the findings of this trial.<\/jats:p>","DOI":"10.1159\/000477999","type":"journal-article","created":{"date-parts":[[2017,8,2]],"date-time":"2017-08-02T21:01:54Z","timestamp":1501707714000},"page":"347-353","source":"Crossref","is-referenced-by-count":15,"title":["Saline Enemas versus Glycerin Suppositories to Promote Enteral Feeding in Premature Infants: A Pilot Randomized Controlled Trial"],"prefix":"10.1159","volume":"112","author":[{"given":"Thowfique","family":"Ibrahim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiang","family":"Li Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dianne","family":"Bautista","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhavani","family":"Sriram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Xiangzhen Fay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor Samuel","family":"Rajadurai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2017,8,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2011-0227"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1159\/000323964"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.3.457"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2008.138024"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2010.190157"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200X.2007.02457.x"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S1055-8586(00)70020-5"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2002.32272"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.01.027"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.1.285"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-0143"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-3634"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-10-1"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1177\/0148607193017006537"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)83550-4"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2013.86"}],"container-title":["Neonatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/477999","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/477999","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:34:55Z","timestamp":1745426095000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000477999"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":16,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2017,11,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000477999","archive":["Portico"],"relation":{},"ISSN":["1661-7800","1661-7819"],"issn-type":[{"type":"print","value":"1661-7800"},{"type":"electronic","value":"1661-7819"}],"subject":[],"published":{"date-parts":[[2017]]}}}