Originales
Lavado gástrico en recién nacidos sanos: un ensayo clínico aleatorio
Gastric lavage in healthy term newborns: a randomized controlled trial
C. Cuello-Garcíaa,
, V. González-Lópeza, A. Soto-Gonzáleza, V. López-Guevarab, S.J. Fernández-Ortizb, M.ªC. Cortez-Hernándezb
Corresponding author
carlos.cuello@itesm.mx
Correspondencia: Dr. C. Cuello-García. Departamento de Pediatría. Escuela de Medicina, ITESM. Avda. Morones Prieto 3000 Pte. Col. Doctores. CP 64710. Monterrey N.L. México.
Correspondencia: Dr. C. Cuello-García. Departamento de Pediatría. Escuela de Medicina, ITESM. Avda. Morones Prieto 3000 Pte. Col. Doctores. CP 64710. Monterrey N.L. México.
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Cuello-García. Departamento de Pediatría. Escuela de Medicina, ITESM. Avda. Morones Prieto 3000 Pte. Col. Doctores. CP 64710. Monterrey N.L. México." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Gastric lavage in healthy term newborns: a randomized controlled trial" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-11-30" "fechaAceptado" => "2005-08-31" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186277" "palabras" => array:3 [ 0 => "Lavado gástrico" 1 => "Procedimientos" 2 => "Alimentación al seno materno" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186278" "palabras" => array:3 [ 0 => "Gastric lavage" 1 => "Procedures" 2 => "Breastfeeding" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p class="elsevierStyleSimplePara elsevierViewall">El lavado gástrico es un método que aún se utiliza en México y otras regiones del mundo sin una evidencia que lo sustente. Se planeó un ensayo aleatorio controlado para probar la hipótesis de que la aspiración del líquido amniótico del estómago del neonato reduce la náusea y el vómito y que produce un incremento en la tolerancia a la primera toma de leche materna o fórmula.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Ensayo aleatorio simple ciego realizado en un hospital general rural en el norte de México. Los recién nacidos sanos elegibles fueron distribuidos de manera aleatoria para realizarles un lavado gástrico (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>63) o simple bservación (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>61). Los resultados que había que evaluar fueron el porcentaje de neonatos con vómito/náusea en las primeras 24 h de vida y la tasa de fracaso de amamantamiento. Esto fue evaluado por una enfermera de manera ciega en el grupo al que fue asignado el recién nacido.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">De los 63 pacientes en el grupo de lavado gástrico, 13 presentaron al menos un episodio de náusea o vómito, comparado con 15 de los 61 del grupo control (riesgo relative [RR]: 0,84; intervalo de confianza [IC] del 95 %: 0,43-1,61). Siete parejas madre-recién nacido en el grupo de lavado gástrico no completaron una alimentación exitosa al seno materno, comparado con cinco en el grupo control (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,8; RR: 0,96; IC 95 %: 0,86-1,08). Otras variables como el sexo del neonato o la tasa de obtención por cesárea no tuvieron efecto sobre el resultado principal. No se comunicaron complicaciones atribuidas al procedimiento. Todos los neonatos fueron dados de alta sin complicaciones.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El lavado o aspirado gástrico en el recién nacido de término y sano es un procedimiento común que debe anularse como práctica diaria en el cunero, ya que no representa ventaja alguna.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">Gastric lavage is still used in Mexico and other countries without evidence to support this practice. We performed a randomized controlled trial to test the hypothesis that elimination of amniotic fluid from the stomach of the newborn reduces nausea and vomiting and improves tolerance on the first feedings of breast or formula milk.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A randomized, single-blind, controlled trial was conducted in a rural general hospital in the north of Mexico. Eligible healthy term newborns were randomly allocated to receive gastric lavage (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>63) or observation (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>61). The primary outcome measures were the presence of nausea and/or emesis in the first 24 hours of life and the breastfeeding failure rate, evaluated by a nurse blinded to the group assignment.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of the 63 patients in the gastric lavage group, 13 had at least one episode of nausea or vomiting compared with 15 out of 61 patients in the control group (relative risk: 0.84; 95 % CI: 0.43 to 1.61). Breastfeeding failure occurred in seven mother-child pairs in the gastric lavage group compared with five in the control group (P<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.8; relative risk: 0.96; 95 % CI: 0.86 to 1.08). Other variables such as sex or cesarian section rate were unrelated to outcome. There were no complications that could be attributed to the procedure. All the newborn infants were discharged without problems.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Gastric aspiration or lavage in the healthy full-term newborn is a common procedure that should be abandoned as it confers no advantages.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A virtually routine procedure. Why!?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Ríos" 1 => "H. Martínez" 2 => "L. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 9 | 15 | 24 |
| 2024 October | 117 | 134 | 251 |
| 2024 September | 91 | 122 | 213 |
| 2024 August | 68 | 160 | 228 |
| 2024 July | 65 | 123 | 188 |
| 2024 June | 72 | 174 | 246 |
| 2024 May | 62 | 114 | 176 |
| 2024 April | 77 | 128 | 205 |
| 2024 March | 73 | 120 | 193 |
| 2024 February | 94 | 135 | 229 |
| 2024 January | 80 | 118 | 198 |
| 2023 December | 130 | 98 | 228 |
| 2023 November | 131 | 157 | 288 |
| 2023 October | 215 | 247 | 462 |
| 2023 September | 306 | 149 | 455 |
| 2023 August | 236 | 125 | 361 |
| 2023 July | 129 | 133 | 262 |
| 2023 June | 113 | 147 | 260 |
| 2023 May | 130 | 150 | 280 |
| 2023 April | 112 | 130 | 242 |
| 2023 March | 194 | 143 | 337 |
| 2023 February | 209 | 132 | 341 |
| 2023 January | 137 | 80 | 217 |
| 2022 December | 102 | 121 | 223 |
| 2022 November | 211 | 101 | 312 |
| 2022 October | 158 | 104 | 262 |
| 2022 September | 166 | 83 | 249 |
| 2022 August | 101 | 168 | 269 |
| 2022 July | 86 | 64 | 150 |
| 2022 June | 82 | 73 | 155 |
| 2022 May | 78 | 248 | 326 |
| 2022 April | 48 | 144 | 192 |
| 2022 March | 80 | 200 | 280 |
| 2022 February | 72 | 140 | 212 |
| 2022 January | 106 | 131 | 237 |
| 2021 December | 154 | 201 | 355 |
| 2021 November | 109 | 254 | 363 |
| 2021 October | 187 | 425 | 612 |
| 2021 September | 164 | 168 | 332 |
| 2021 August | 106 | 98 | 204 |
| 2021 July | 109 | 63 | 172 |
| 2021 June | 84 | 99 | 183 |
| 2021 May | 76 | 133 | 209 |
| 2021 April | 131 | 186 | 317 |
| 2021 March | 109 | 104 | 213 |
| 2021 February | 116 | 74 | 190 |
| 2021 January | 90 | 107 | 197 |
| 2020 December | 93 | 106 | 199 |
| 2020 November | 58 | 124 | 182 |
| 2020 October | 95 | 228 | 323 |
| 2020 September | 62 | 194 | 256 |
| 2020 August | 50 | 218 | 268 |
| 2020 July | 51 | 136 | 187 |
| 2020 June | 67 | 195 | 262 |
| 2020 May | 54 | 142 | 196 |
| 2020 April | 37 | 150 | 187 |
| 2020 March | 37 | 162 | 199 |
| 2020 February | 65 | 205 | 270 |
| 2020 January | 69 | 184 | 253 |
| 2019 December | 77 | 191 | 268 |
| 2019 November | 77 | 254 | 331 |
| 2019 October | 39 | 326 | 365 |
| 2019 September | 48 | 530 | 578 |
| 2019 August | 42 | 319 | 361 |
| 2019 July | 57 | 310 | 367 |
| 2019 June | 56 | 433 | 489 |
| 2019 May | 136 | 528 | 664 |
| 2019 April | 317 | 500 | 817 |
| 2019 March | 425 | 450 | 875 |
| 2019 February | 300 | 414 | 714 |
| 2019 January | 171 | 481 | 652 |
| 2018 December | 53 | 436 | 489 |
| 2018 November | 64 | 617 | 681 |
| 2018 October | 77 | 395 | 472 |
| 2018 September | 48 | 304 | 352 |
| 2018 August | 10 | 0 | 10 |
| 2018 July | 8 | 0 | 8 |
| 2018 June | 4 | 0 | 4 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 13 | 0 | 13 |
| 2018 March | 13 | 0 | 13 |
| 2018 February | 16 | 3 | 19 |
| 2018 January | 8 | 0 | 8 |
| 2017 December | 15 | 0 | 15 |
| 2017 November | 23 | 0 | 23 |
| 2017 October | 31 | 0 | 31 |
| 2017 September | 19 | 0 | 19 |
| 2017 August | 19 | 0 | 19 |
| 2017 July | 25 | 12 | 37 |
| 2017 June | 48 | 267 | 315 |
| 2017 May | 67 | 283 | 350 |
| 2017 April | 66 | 309 | 375 |
| 2017 March | 66 | 358 | 424 |
| 2017 February | 79 | 482 | 561 |
| 2017 January | 51 | 192 | 243 |
| 2016 December | 49 | 251 | 300 |
| 2016 November | 108 | 363 | 471 |
| 2016 October | 79 | 378 | 457 |
| 2016 September | 121 | 557 | 678 |
| 2016 August | 328 | 433 | 761 |
| 2016 July | 133 | 352 | 485 |
| 2016 June | 2 | 0 | 2 |
| 2016 May | 7 | 0 | 7 |
| 2016 April | 5 | 0 | 5 |
| 2016 March | 5 | 370 | 375 |
| 2016 February | 3 | 0 | 3 |
| 2016 January | 8 | 0 | 8 |
| 2015 December | 5 | 0 | 5 |
| 2015 November | 12 | 0 | 12 |
| 2015 October | 8 | 577 | 585 |
| 2015 September | 8 | 0 | 8 |
| 2015 August | 10 | 0 | 10 |
| 2015 July | 46 | 341 | 387 |
| 2015 June | 33 | 223 | 256 |
| 2015 May | 35 | 376 | 411 |
| 2015 April | 31 | 306 | 337 |
| 2015 March | 29 | 378 | 407 |
| 2015 February | 33 | 336 | 369 |
| 2015 January | 38 | 52 | 90 |
| 2014 December | 61 | 15 | 76 |
| 2014 November | 39 | 9 | 48 |
| 2014 October | 56 | 3 | 59 |
| 2014 September | 63 | 6 | 69 |
| 2014 August | 50 | 2 | 52 |
| 2014 July | 60 | 5 | 65 |
| 2014 June | 120 | 6 | 126 |
| 2014 May | 310 | 4 | 314 |
| 2014 April | 295 | 2 | 297 |
| 2014 March | 325 | 104 | 429 |
| 2014 February | 312 | 83 | 395 |
| 2014 January | 315 | 9 | 324 |
| 2013 December | 289 | 13 | 302 |
| 2013 November | 383 | 15 | 398 |
| 2013 October | 476 | 10 | 486 |
| 2013 September | 378 | 23 | 401 |
| 2013 August | 396 | 39 | 435 |
| 2013 July | 248 | 5 | 253 |
| 2013 June | 8 | 1 | 9 |
| 2013 May | 7 | 3 | 10 |
| 2013 April | 10 | 3 | 13 |
| 2013 March | 9 | 2 | 11 |
| 2013 February | 26 | 2 | 28 |
| 2013 January | 28 | 0 | 28 |
| 2012 December | 21 | 0 | 21 |
| 2012 November | 20 | 1 | 21 |
| 2012 October | 26 | 2 | 28 |
| 2012 September | 4 | 0 | 4 |
| 2005 December | 13640 | 0 | 13640 |
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