Esophageal Impedance Baseline Is Age Dependent

Salvatore, S.; Salvatoni, Alessandro; Berkel, Marieke Van; Steen, Kristel Van; Unmarino, Dario; Ghanma, Abdallah; Hauser, Bruno; Vandenplas, Yvan

doi:10.1097/mpg.0b013e31829b68cd

Cited by 21 publications

(33 citation statements)

References 16 publications

(31 reference statements)

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“…Conversely, some reports have indicated a significant positive correlation between the BI and age and a significant relationship between the BI and esophageal motility was found in the current investigation. Salvatore et al.…”

Section: Discussioncontrasting

confidence: 90%

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A baseline impedance analysis in neurologically impaired children: A potent parameter for estimating the condition of the esophageal mucosa

Fukahori

Yagi

Ishii

et al. 2017

Neurogastroenterology Motil

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Section: Discussioncontrasting

confidence: 90%

“…Salvatore et al. speculated that the positive correlation between the BI and age up to 4 years is due to a change in the amount of air around the impedance sensor, which increases as the diameter of the esophagus grows with age …”

Section: Discussionmentioning

confidence: 99%

A baseline impedance analysis in neurologically impaired children: A potent parameter for estimating the condition of the esophageal mucosa

Fukahori

Yagi

Ishii

et al. 2017

Neurogastroenterology Motil

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“…Impedance baseline has recently emerged as an additional esophageal impedance (multiple intraluminal esophageal impedance [MII]) parameter possibly related to esophageal integrity . Pediatric data are currently controversial, limited to small series of patients, and likely influenced by drug treatment and age . A predictive marker of esophagitis is currently lacking but would be helpful to select patients to submit to endoscopy and to assess efficacy of treatment as an indirect marker of healing of esophagitis.…”

Section: Introductionmentioning

confidence: 99%

Low mean impedance in 24-hour tracings and esophagitis in children: a strong connection

Salvatore¹,

Salvatoni²,

Ummarino

et al. 2014

Dis Esophagus

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Esophageal multiple intraluminal impedance baseline is an additional impedance parameter that was recently related to esophageal integrity. The aim of this study was to assess the relationship between mean esophageal impedance value and endoscopic findings in a large group of children. Children with symptoms of gastroesophageal reflux submitted to both endoscopy and impedance were included. Esophagitis was graded according to the Los Angeles classification. Mean impedance value was automatically calculated over 24-hour tracings. Data were adjusted for age through z-score transformation using percentiles normalized by the LMS (Lambda for the skew, Mu for the median, and Sigma for the generalized coefficient of variation) method. Nonparametric Mann-Whitney and Kruskal-Wallis tests, multiple, and stepwise regression were used. P-value <0.05 was considered as statistically significant. A total of 298 impedance tracings were analyzed. Endoscopic and histological esophagitis were detected in 30 and 29% patients, respectively. Median baseline z-score was significantly decreased both in proximal (P = 0.02) and distal (P = 0.01) esophagus in patients with endoscopic (but not histological) esophagitis. Patients with more severe esophagitis showed the lowest z-score. Bolus exposure index and the number of reflux episodes were the variables that were significantly associated with the baseline z-score. Impedance z-score is significantly decreased in infants and children with endoscopic esophagitis. Severity of esophagitis, bolus exposure index, and number of reflux episodes are factors influencing mean esophageal impedance.

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“…Infants and young children previously were shown to have a lower baseline impedance when compared to older (pediatric) patients [37]. Age, however, did not influence the effect of LARS on baseline impedance.…”

Section: Discussionmentioning

confidence: 88%

Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease

et al. 2016

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BackgroundEsophageal intraluminal baseline impedance reflects the conductivity of the esophageal mucosa and may be an instrument for in vivo evaluation of mucosal integrity in children with gastroesophageal reflux disease (GERD). Laparoscopic antireflux surgery (LARS) is a well-established treatment option for children with proton pump inhibitory (PPI) therapy resistant GERD. The effect of LARS in children on baseline impedance has not been studied in detail. The aim of this study was to evaluate the effect of LARS on baseline impedance in children with GERD.MethodsThis is a prospective, multicenter, nationwide cohort study (Dutch national trial registry: NTR2934) including 25 patients [12 males, median age 6 (range 2–18) years] with PPI-resistant GERD scheduled to undergo LARS. Twenty-four hour multichannel intraluminal impedance pH monitoring (MII-pH monitoring) was performed before and 3 months after LARS. Baseline impedance was evaluated during consecutive 2-h intervals in the 24-h tracings.ResultsLARS reduced acid exposure time from 8.5 % (6.0–16.2 %) to 0.8 % (0.2–2.8 %), p < 0.001. Distal baseline impedance increased after LARS from 2445 Ω (1147–3277 Ω) to 3792 Ω (3087–4700 Ω), p < 0.001. Preoperative baseline impedance strongly correlated with acid exposure time (r −0.76, p < 0.001); however, no association between symptomatic outcome and baseline impedance was identified.ConclusionsLARS significantly increased baseline impedance likely reflecting recovery of mucosal integrity. As the change in baseline impedance was not associated with the clinical outcome of LARS, other factors besides mucosal integrity may contribute to symptom perception in children with GERD.

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Esophageal Impedance Baseline Is Age Dependent

Abstract: IB is significantly lower in infants (especially in the first months of life) compared with older children. Low IB in both proximal and distal esophagus in young infants may be related to anatomical and functional difference other than the presence of esophagitis.

Cited by 21 publications

References 16 publications

A baseline impedance analysis in neurologically impaired children: A potent parameter for estimating the condition of the esophageal mucosa

A baseline impedance analysis in neurologically impaired children: A potent parameter for estimating the condition of the esophageal mucosa

Low mean impedance in 24-hour tracings and esophagitis in children: a strong connection

Esophageal mucosal integrity improves after laparoscopic antireflux surgery in children with gastroesophageal reflux disease

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