Analyses of the relationship between a ‘number of reflux episodes’ exceeding 70 and the pH index in neurologically impaired children by evaluating esophageal combined pH-multichannel intraluminal impedance measurements

Fukahori, Suguru; Yagi, Minoru; Ishii, Shinji; Asagiri, Kimio; Saikusa, Nobuyuki; Hashizume, Naoki; Yoshida, Misao; Masui, Daisuke; Higashidate, Naruki; Sakamoto, Saki; Nakahara, Hiroyuki; Tanaka, Yoshiaki

doi:10.1080/00365521.2017.1393558

Cited by 7 publications

(5 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We know acids produce the breakup of the intercellular junctional complexes; subsequently, a paracellular leak occurs with intercellular space dilatation; this damaged epithelium has a lower electrical resistance than healthy epithelium, which means a lower impedance in the pH‐MII (9). This event was demonstrated in the present study, in which the mean BI at channel 6 was significantly lower in a patient with pathological AET than normal AET, as well as other publications in children (37,39,43,44); Likewise, the MNBI values at channel 6 were significantly lower in those patients; this inverse correlation between the AET and the MNBI has been proved in a study performed in the adult population (45); but, more information is lacking in children, and we only found 1 study (42). The results at channel 5 were not statistically significant.…”

Section: Discussionsupporting

confidence: 83%

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.

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 83%

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.

View full text Add to dashboard Cite

show abstract

“…This tendency is observed despite the following statement in the guideline for pediatric 24-h esophageal pH monitoring: "it is vital that the diagnosis of GERD be made comprehensively by considering the simultaneity between the observed symptoms and the reflux events during pH monitoring, irrespective of RI > 4.0%". We reported that the number of REs: 70, corresponds to GERD with RI of 9.2%, in which neurologically impaired patients suffer severe acid exposure [19]. Therefore, this MII-pH parameter may be more useful than RI in determining the indication for the fundoplication procedure.…”

Section: Discussionmentioning

confidence: 97%

Standard protocol devised by the Japanese Pediatric Impedance Working Group for combined multichannel intraluminal impedance-pH measurements in children

et al. 2019

Self Cite

View full text Add to dashboard Cite

Multichannel intraluminal impedance-pH measurements (MII-pH) are useful for evaluating acid and non-acid gastroesophageal reflux (GER). However, the use of MIH-pH is not yet established in Japan. The Japanese Pediatric Impedance Working Group (Japanese-PIG) convened to devise a standard protocol for MII-pH in Japanese children. The expert members of the Japanese-PIG collected data on pediatric MII-pH from the relevant literature in English, including the standard protocol of MII-pH presented by the European PIG, and the insights of international experts. The resultant consensus was included in the contents of the standard protocol of MII-pH. The standard protocol included standardization of the indication, methodology, and interpretation of MII-pH in Japanese children. The criteria for abnormal GER by MII-pH were defined using the Reflux Index and number of total reflux episodes independently in children aged < 1 year and those aged ≥ 1 year. Moreover, a significant relationship between GER and symptoms was identified using the symptom index and symptom association probability approach. We conclude that the current version of the protocol for MII-pH is tentative because it is not based on data from Japanese children. Further studies are needed to render this protocol clinically beneficial and expand its use in Japan.

show abstract

“…The 102 published clinical studies about children with SNI fall into seven clinical topics. Gastroesophageal reflux and feeding tubes ( n = 57, 56%) was the most common topic, with subtopics of gastroesophageal reflux ( n = 7), 7,42–44,102–104 gastrostomy tube outcomes ( n = 24), 9,39,45,46,56–65,81–84,105–110 and antireflux procedures ( n = 26) 8,47–55,66–71,85,86,111–118 . Other topics included aspiration and respiratory issues ( n = 13, 13%) 72,73,87–93,119–122 ; symptoms, palliative care, and quality of life ( n = 12, 12%) 38,41,74–77,94–97,123,124 ; growth and endocrinology ( n = 10, 10%) 78,98,99,125–131 ; caregivers and care burden ( n = 7, 7%) 10,37,40,79,80,100,132 ; other ( n = 2, 2%) 101,133 ; and musculoskeletal ( n = 1, 1%) 134 .…”

Section: Resultsmentioning

confidence: 99%

Section: Primary Topics Of Studiesmentioning

confidence: 99%

Clinical characteristics of children with severe neurologic impairment: A scoping review

Nelson

Finlay

Huang

et al. 2022

Journal of Hospital Medicine

View full text Add to dashboard Cite

Objective: The aim of this study is to extrapolate the clinical features of children with severe neurologic impairment (SNI) based on the functional characteristics and comorbidities described in published studies.Methods: Four databases were searched. We included studies that describe clinical features of a group of children with SNI (≥20 subjects <19 years of age with >1 neurologic diagnosis and severe functional limitation) using data from caregivers, medical charts, or prospective collection. Studies that were not written in English were excluded. We extracted data about functional characteristics, comorbidities, and study topics. Results:We included 102 studies, spanning 5 continents over 43 years, using 41 distinct terms for SNI. The terms SNI and neurologic impairment (NI) were used in 59 studies (58%). Most studies (n = 81, 79%) described ≥3 types of functional

show abstract

Analyses of the relationship between a ‘number of reflux episodes’ exceeding 70 and the pH index in neurologically impaired children by evaluating esophageal combined pH-multichannel intraluminal impedance measurements

Abstract: The present study indicates that NoRE 70 corresponds to GERD in which patients suffer severe acid exposure with pH of around 9% and esophageal mucosal damage with low BI value in NI children.

Cited by 7 publications

References 26 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

Standard protocol devised by the Japanese Pediatric Impedance Working Group for combined multichannel intraluminal impedance-pH measurements in children

Clinical characteristics of children with severe neurologic impairment: A scoping review

Contact Info

Product

Resources

About