Esophageal dysmotility and the sudden infant death syndrome: clinical experience.

Schey, William L.; Replogle, Robert L.; Campbell, CB; Meus, P; Levinsky, R A

doi:10.1148/radiology.140.1.6787662

Cited by 11 publications

(6 citation statements)

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“…Results of the present study on cardiorespiratory reflexes from esophageal origin are reminiscent of our previous observations on laryngeal chemoreflexes in preterm vs. full-term lambs (52,53). Immaturity of the brain stem cardiorespiratory "controllers" (6), perhaps with increased esophageal receptor sensitivity and/or immature control by higher brain centers (48), is likely involved in the heightened inhibitory responses observed in preterm lambs. Moreover, the observation that double stimulations induced the most powerful inhibition may be related to the summative effect of simultaneous stimulation of the distal and proximal esophagus.…”

Section: New Knowledge Revealed By the Present Studysupporting

confidence: 80%

Reflex cardiorespiratory events from esophageal origin are heightened by preterm birth

Nault

Samson

Nadeau

et al. 2017

Journal of Applied Physiology

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The involvement of gastroesophageal refluxes in cardiorespiratory events of preterm infants remains controversial. While a few studies in full-term newborn animals have shown that stimulation of esophageal receptors leads to cardiorespiratory reflexes, the latter remain largely unknown, especially after premature birth. The present study aimed to ) characterize the cardiorespiratory reflexes originating from esophageal receptors in newborn lambs and) test the hypotheses that preterm birth enhances reflex cardiorespiratory inhibition and that C-fibers are involved in these reflexes. Eight full-term lambs and 10 lambs born 14 days prematurely were studied. Following surgical instrumentation, a 6-h polysomnography was performed without sedation to record electrocardiogram, respiratory movements, arterial pressure, laryngeal constrictor muscle activity, state of alertness, and hemoglobin oxygen saturation. Five esophageal stimulations of the upper and/or lower esophagus, including rapid balloon inflation and/or HCl injection, were performed in random order. A second recording was performed in full-term lambs 24 h later, after C-fiber blockade by capsaicin. Results confirmed that esophageal stimulations induced inhibitory cardiorespiratory reflexes combined with protective mechanisms, including laryngeal closure, swallowing, coughing, increased arterial pressure, and arousal. Preterm birth heightened cardiorespiratory inhibition. The strongest cardiorespiratory inhibition was observed following simultaneous stimulation of the lower and upper esophagus. Finally, cardiorespiratory inhibition was decreased after C-fiber blockade. In conclusion, esophageal stimulation induces inhibitory cardiorespiratory reflexes, which are partly mediated by C-fibers and more pronounced in preterm lambs. Clinical relevance of these findings requires further studies, especially in conditions associated with increased cardiorespiratory events, e.g., neonatal infection. Preterm birth heightens the cardiorespiratory events triggered by esophageal stimulation. The most extensive cardiorespiratory events are induced by simultaneous stimulation of the proximal and distal esophagus.

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Section: New Knowledge Revealed By the Present Studysupporting

confidence: 80%

Reflex cardiorespiratory events from esophageal origin are heightened by preterm birth

Nault

Samson

Nadeau

et al. 2017

Journal of Applied Physiology

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“…In infants with CGV, the associations of GERD and esophageal dysmotility were found in 62% and 20%, respectively. It can therefore be considered that the condition of CGV mgiht affect the esophageal motility and lower esophageal sphincter (LES) function resulting in GERD 17,18 . There is some published literature supporting the thesis that esophageal dysmotility can be responsible for ALTE 18−20 .…”

Section: Discussionmentioning

confidence: 99%

“…It can therefore be considered that the condition of CGV mgiht affect the esophageal motility and lower esophageal sphincter (LES) function resulting in GERD. 17,18 There is some published literature supporting the thesis that esophageal dysmotility can be responsible for ALTE. [18][19][20] Chronic gastric volvulus is a condition in which all or part of stomach rotates over the physiological range.…”

Section: Manometric Study Esophageal Dysmotilities As Defined As Simumentioning

confidence: 98%

“…17,18 There is some published literature supporting the thesis that esophageal dysmotility can be responsible for ALTE. [18][19][20] Chronic gastric volvulus is a condition in which all or part of stomach rotates over the physiological range. In neonates and young infants the fixation of the stomach with the ligaments is very weak.…”

Section: Manometric Study Esophageal Dysmotilities As Defined As Simumentioning

confidence: 98%

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Discharge diagnoses in infants with apparent life‐threatening event

Okada

Miyako²,

Honma³

et al. 2003

Pediatrics International

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“…t)80 18 17 ID IS14 12 ia 11 ID cm Gastroesophageal manometric study with stationary pullthrough method in Case I. (a) Recording before medication:(b) recording at an hour after the administration of atropine sulfate: and (c) recording one month after the end of treatment.…”

mentioning

confidence: 99%

Etiology of 19 infants with apparent life‐threatening events: Relationship between apnea and esophageal dysfunction

Tsukada

Kosuge

Hosokawa

et al. 1993

Pediatrics International

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There are various identifiable diseases or conditions that can cause apparent life‐threatening events (ALTE; e.g. gastroesophageal reflux (GER) and seizures). Nineteen infants with ALTE (mean age: 4.3 months) were brought to our hospital between June 1986 and August 1991. The causes of these ALTE were investigated. Analysis of laboratory data, radiological studies and esophageal function tests led to the diagnosis of GER in six of 19 infants; pertussis in five; upper respiratory infection in three; vagotonia‐like condition with esophageal dysfunction in two; laryngostenosis with cerebral palsy in two; choking on food or drink in two; and epilepsy in one infant. Two cases (one case of pertussis and one of vagotonia‐like condition) were associated with GER. Some of the cases demonstrate that ALTE in infants may be induced by GER or some esophageal dysmotility. Further studies of ALTE are needed to ascertain how frequently GER or esophageal dysmotility is responsible for ALTE.

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Esophageal dysmotility and the sudden infant death syndrome: clinical experience.

Cited by 11 publications

References 0 publications

Reflex cardiorespiratory events from esophageal origin are heightened by preterm birth

Reflex cardiorespiratory events from esophageal origin are heightened by preterm birth

Discharge diagnoses in infants with apparent life‐threatening event

Etiology of 19 infants with apparent life‐threatening events: Relationship between apnea and esophageal dysfunction

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