A new method to estimate catheter length for esophageal multichannel intraluminal impedance monitoring in children

Mutalib, Mohamed; Sintusek, Palittiya; Punpanich, Dollapas; Thapar, Nikhil; Lindley, Keith

doi:10.1111/nmo.12547

Cited by 17 publications

(7 citation statements)

References 16 publications

(28 reference statements)

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“…Histamine 2 (H2) blockade and prokinetics were stopped 48 hours before the study; proton pump inhibitors were stopped 7 days before the study; and antacids were stopped 6 hours before the study. The patients were intubated through the nose, and the Strobel formula (0.252 Â body length [cm] þ 5) (14) or Great Ormond Street Hospital table (15) was used to estimating the appropriate probe location. The catheter position was corrected by X-ray.…”

Section: What Is Newmentioning

confidence: 99%

Low Mean Nocturnal Baseline Impedance is Associated With a Pathological Acid Exposure Time in Children

Rosado-Arias

Monjaráz

Cervantes-Bustamante

et al. 2021

J. pediatr. gastroenterol. nutr.

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Background: The baseline impedance (BI) and the mean nocturnal baseline impedance (MNBI) serve as markers of mucosal integrity in patients with pathologic acid exposure time (AET). This work aims to investigate the association between the BI and MNBI with the AET in children. Methodology: A retrospective study was performed in children 18 years old with suspicion of gastroesophageal reflux disease who underwent both endoscopy and pH-impedance monitoring (pH-MII). Esophagitis was graded according to the Los Angeles classification. The pathological AET was determined depending on the age (!5% in patients >1 year and !10% in those ages 1 year). For the BI, 60 s measurements were taken every 4 h, and for the MNBI, 3 10 min measurements were taken between 1.00 and 3:00 AM; then, they were averaged. The means of BI and MNBI were compared with each other, with the AET, and other variables. Results: Sixty-eight patients were included, 25% of patients presented pathological AET. The mean of the MNBI was higher than BI in channels 6 (2195 vs 1997 V, P ¼ 0.011) and 5 (2393 vs 2228 V, P ¼ 0.013). BI and MNBI at channel 6 were lower in patients with pathological AET than in those with normal AET (1573 vs 2138 V, P ¼ 0.007) and (1592 vs 2396 V, P ¼ 0.004), respectively. Conclusions: Children with pathological AET had lower impedance values than those with normal AET. BI and MNBI measurements should be part of the routine MII-pH assessment in children.

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Section: What Is Newmentioning

confidence: 99%

Low Mean Nocturnal Baseline Impedance is Associated With a Pathological Acid Exposure Time in Children

Rosado-Arias

Monjaráz

Cervantes-Bustamante

et al. 2021

J. pediatr. gastroenterol. nutr.

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“…More recently, other authors have reported equations to predict optimal esophageal intraluminal impedance probe placement in children. Two studies found a strong linear correlation between probe distance from the nares and the height of the child: Mutalib et al (2015) recorded a Pearson correlation coefficient of 0.95 in 144 children aged 1 month to 16 years, and Nowak et al (2015) an r value of 0.97 in 353 patients aged 0.1–18.9 years. However, the impedance/pH probe is optimally positioned two vertebral bodies above the diaphragm (uncontrolled for respiration) on a chest radiograph and so these studies do not provide data on EL.…”

Section: Discussionmentioning

confidence: 99%

“…Statistical significance was set at p < 0.05. The success rate of each model was defined as the proportion of children for whom the predicted distance (EL or EGJ) was <1/12 of the predicted thoracic spine length, as per previous studies (Arcos‐Machancoses et al, 2019; Mutalib et al, 2015). Thoracic spine length was calculated using the equation derived by Currarino et al (1986) based on 331 children in Texas.…”

Section: Methodsmentioning

confidence: 99%

Esophageal length in children: Reference data and a novel predictive equation

Tinawi

Stringer

2021

Clinical Anatomy

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Minimal information exists on the length of the child's esophagus, namely the distance from the cricopharyngeus to the esophagogastric junction (EGJ). We aimed to investigate the relationship between esophageal length (EL) and the age, height, and weight of the child. Children undergoing upper gastrointestinal endoscopy between February 2019 and May 2021 at our institution were prospectively audited. Children with anatomical esophageal disorders were excluded. Endoscopic distances from the incisors to the cricopharyngeus and EGJ were obtained, and novel predictive equations derived to predict EL. Intra‐observer agreement for endoscopic measurements showed an intra‐class correlation coefficient of 0.99. A total of 290 children aged 0.4–17.3 years were included in the analysis; they were divided into a model development cohort (n = 261) and a model validation cohort (n = 29). Measured EL correlated best with height (r = 0.92) as compared to age (r = 0.90) or weight (r = 0.83). The optimal equation for predicting EL was 0.156 × height (cm) – 1.336 (adjusted R2 = 0.841); this had a success rate of 76% in the validation cohort. The optimal equation for predicting distance from incisors to EGJ was 0.199 × height (cm) + 6.470 (adjusted R2 = 0.889); this had a success rate of 69% in the validation cohort. This is the first study to report a predictive equation for estimating esophageal length in children. Accurate prediction of esophageal length may assist with clinical esophageal procedures in children such as nasogastric and pH probe placement.

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“…This formula is not as accurate in older children as it overestimates the oesophageal length. Mutalib et al 16 (table 2) described an accurate method to estimate catheter length in children based on their body length. The placement of the distal pH should be estimated at 1.5 cm (infants), 3 cm (<10 years old) or 5 cm (>10 years old) above the LOS if placed endoscopically; however, fluoroscopic or X-ray confirmation of position is essential.…”

Section: Placement Of Cathetermentioning

confidence: 99%

BSPGHAN Motility Working Group position statement: paediatric multichannel intraluminal pH impedance monitoring—indications, methods and interpretation

Mutalib

Rawat

Lindley

et al. 2017

Frontline Gastroenterol

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A new method to estimate catheter length for esophageal multichannel intraluminal impedance monitoring in children

Cited by 17 publications

References 16 publications

Low Mean Nocturnal Baseline Impedance is Associated With a Pathological Acid Exposure Time in Children

Low Mean Nocturnal Baseline Impedance is Associated With a Pathological Acid Exposure Time in Children

Esophageal length in children: Reference data and a novel predictive equation

BSPGHAN Motility Working Group position statement: paediatric multichannel intraluminal pH impedance monitoring—indications, methods and interpretation

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