Risk factors for gastroesophageal reflux disease in very low birth weight infants with bronchopulmonary dysplasia

Mendes, Thais Biude; Mezzacappa, Maria Aparecida M. S.; Toro, Adyléia Aparecida Dalbo Contrera; Ribeiro, José Dirceu

doi:10.2223/jped.1764

Cited by 16 publications

(9 citation statements)

References 31 publications

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“…In addition, the low gestational age contributed to the presence of respiratory failure in the first week of life, which in turn is a risk factor for high RI [30,31]. Likewise, the minimum chronological age of 28 days, in order to standardize the postmenstrual age among groups [17], hindered the inclusion of healthy newborns in the group that did not present BPD, due to a shorter hospital stay.…”

Section: Discussionmentioning

confidence: 99%

“…The equipment used for pH registering was Digitrapper MKIII-Medtronic Synectics®, Stockholm, Sweden. Technical calibration procedures and equipment installation were previously described [17]. The electrode was introducedup to the distance established by the arithmetical average of the length obtained by the pH turning point and location of the Lower Esophageal Sphincter (LES) determined by manometry [18].…”

Section: Methodsmentioning

confidence: 99%

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High Prevalence of Esophageal Acid Exposure in Very Low Birth Weight Infants Presenting or Not Bronchopulmonary Dysplasia: A Prospective Cross-Sectional Study

Mezzacappa¹

2014

J Neonatal Biol

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IntroductionBronchopulmonary dysplasia (BPD) affects about 22% of very low birth weight (VLBW) newborns [1]. The disease has a turbulent clinical course, significantly contributing to morbidity and mortality in the neonatal period, and leaving long-term sequelae [2].The frequency of Gastroesophageal Reflux (GER) causing symptoms and a complicated clinical course in premature infants presenting BPD during their stay in neonatal care units is not fully established [3][4][5] and widely questioned.Although there is experimental and clinical evidence that sleep apnea occurs as a result of reflux episodes [6,7], the cause-effect relation between the conditions is controversial [8][9][10]. Similarly there is disagreement regarding the effects of GER in the pathogenesis and in BPD recovery [5,11]. The presence of pepsin in the tracheal aspirate in ventilated newborns during the first weeks of life, and the subsequent progression to BPD in these newborns may indicate the possibility of chronic aspiration as a mechanism in the genesis of BPD [12]. Furthermore, there is evidence that symptoms associated with acid reflux episodes that reach or not the pharynx, if cleared slowly, are common in newborns presenting BPD on respiratory support [13,14].Despite the controversies, the presumptive diagnosis of GER has been quite frequent in neonatal units in North America, and there is indication that 24.8% of VLBW infants are treated for the condition [15]. Treatment is even more common (47.6%) among VLBW infants who are discharged after 42 weeks of postmenstrual age, of which 75.7% have DBP [15].Given the uncertainty regarding the occurrence of GER in newborns presenting BPD and the frequency of GER treatment, the prospective study of distal esophagic pH monitoring (DEpHM) abnormalities in newborn infants presenting or not BPD was considered. AbstractBackground: A high frequency of treatment for gastroesophageal reflux disease is observed in neonates with Bronchopulmonary Dysplasia (BPD). The association between these illnesses is controversial.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

High Prevalence of Esophageal Acid Exposure in Very Low Birth Weight Infants Presenting or Not Bronchopulmonary Dysplasia: A Prospective Cross-Sectional Study

Mezzacappa¹

2014

J Neonatal Biol

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“…19 They also have lower cognitive abilities and performances at school; 20 they suffer from reduced motor skills gastroesophageal reflux disease, 21 hearing loss and ROP. 22 Moreover, these patients frequently experience problems in height and weight growth and a reduced fat storage.…”

Section: Nutrition At Dischargementioning

confidence: 99%

Nutritional problems of children with bronchopulmonary dysplasia after hospital discharge

et al. 2017

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The last decades have seen significant improvements in the care of premature infants. The introduction of new approaches, especially in the ventilatory management, have led to significant increase of survival rate of low and extremely low gestational age infants. These populations of neonates, however, often experience prolonged mechanical ventilation, which is widely recognized to be closely related to bronchopulmonary dysplasia (BPD) development.The management of BPD, which is a multifactorial disease, requires a multidisciplinary approach and remains challenging for all the physicians involved. In fact, short and long-term sequelae are not only related to pulmonary performances but include neurological impairment and growth deficiency.A proper nutrition management since the very first days has shown to significantly contribute to the optimal maturation and functionality of the lung.In this paper, we aim to give an overall of the main principles of nutrition in infants born prematurely, with specific regard to the interventions, which could be relevant in infants affected by BPD.

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“…There is little, if any, clinical evidence that furosemide has an effect on gastrointestinal motility. Several case–control retrospective studies (66–68) have looked for associations between GER and medication use, including caffeine, surfactant, opioid, dopamine, prenatal and postnatal corticosteroids and bronchodilators. It would appear that even though furosemide is a drug with manifold pharmacologic actions, it has not been critically scrutinized as a risk factor for GER.…”

Section: Possible Effects Of Loop Diuretics On the Gastrointestinal Tmentioning

confidence: 99%

Unexpected extra‐renal effects of loop diuretics in the preterm neonate

2012

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The loop diuretics furosemide and bumetanide are commonly used in neonatal intensive care units (NICUs). Furosemide, due to its actions on the ubiquitous NKCC1 co-transporter and its promotion of prostanoid production and release, also has non-diuretic effects on vascular smooth muscle, airways, the ductus arteriosus, and theoretically the gastrointestinal tract. Loop diuretics also affect the central nervous system through the inhibitory neurotransmitter, GABA. Conclusion The loop diuretics have a variety of biological effects that are potentially harmful as well as beneficial. Care should be taken with the use of these agents since the range of their effects may be broader than the single action sought by the prescribing physician.

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Risk factors for gastroesophageal reflux disease in very low birth weight infants with bronchopulmonary dysplasia

Cited by 16 publications

References 31 publications

High Prevalence of Esophageal Acid Exposure in Very Low Birth Weight Infants Presenting or Not Bronchopulmonary Dysplasia: A Prospective Cross-Sectional Study

High Prevalence of Esophageal Acid Exposure in Very Low Birth Weight Infants Presenting or Not Bronchopulmonary Dysplasia: A Prospective Cross-Sectional Study

Nutritional problems of children with bronchopulmonary dysplasia after hospital discharge

Unexpected extra‐renal effects of loop diuretics in the preterm neonate

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