Maturation of Esophageal Motility and Esophagogastric Junction in Preterm Infants

Rayyan, Maissa; Omari, Taher; Naulaers, Gunnar; Aerts, Raf; Allegaert, Karel; Rommel, Nathalie

doi:10.1159/000506481

Cited by 7 publications

(8 citation statements)

References 32 publications

(48 reference statements)

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“…Commercial HRM catheters of 8‐French size, including a feeding lumen, are available. Thus HRM is technically viable in the paediatric setting, even in premature infants 5–10 . There is an emerging paediatric oesophageal motility literature showing that the spectrum of HRM‐classified motility disorders resembles that described for adults 11–13 .…”

Section: High‐resolution Oesophageal Manometrymentioning

confidence: 99%

“…Thus HRM is technically viable in the paediatric setting, even in premature infants. [5][6][7][8][9][10] There is an emerging paediatric oesophageal motility literature showing that the spectrum of HRMclassified motility disorders resembles that described for adults. [11][12][13] However, there are still major challenges for standardisation to enable reliable and meaningful results for routine clinical use.…”

Section: Considerations Specific To Paediatricsmentioning

confidence: 99%

See 1 more Smart Citation

What is the role of high‐resolution oesophageal manometry in paediatrics?

Omari

Krishnan

2020

J Paediatrics Child Health

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Abnormal oesophageal motility may impair oesophageal bolus transport leading to symptoms of chest pain and regurgitation. Oesophageal pathophysiology may include neuromuscular and/or structural defects leading to weak, incoordinate or absent peristalsis and impaired oesophago‐gastric junction relaxation. Understanding these mechanisms is important to determine the appropriate course of therapy. Whilst, barium oesophagram is the mainstay for clinical investigation of oesophageal motility, high‐resolution manometry is now more widely available. This review describes the potential value of high‐resolution manometry in paediatric gastroenterology practise.

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Section: High‐resolution Oesophageal Manometrymentioning

confidence: 99%

Section: Considerations Specific To Paediatricsmentioning

confidence: 99%

What is the role of high‐resolution oesophageal manometry in paediatrics?

Omari

Krishnan

2020

J Paediatrics Child Health

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“…The healthy, preterm infants were studied as part of a parallel research study investigating maturational trends over time in preterm infants. 17,18 The manometric studies at term age in preterm infants and the data collected in the healthy term infants were used as control data for the current study.…”

Section: Control Patientsmentioning

confidence: 99%

Characterization of esophageal motility and esophagogastric junction in preterm infants with bronchopulmonary dysplasia

Rayyan

Omari

Debeer

et al. 2020

Neurogastroenterology Motil

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Background: To characterize esophageal motility and function of the esophagogastric junction (EGJ) in preterm infants with bronchopulmonary dysplasia (BPD). Methods: High-resolution manometry with impedance was used to investigate esophageal motility and EGJ function in 28 tube-fed preterm infants with BPD. Patients with BPD were studied at term age during oral feeding. Thirteen healthy term-aged infants were included as controls. Esophageal analysis derived objective measures to evaluate esophageal contractile vigor, bolus distension pressure, EGJ relaxation, and EGJ barrier function (in rest and during respiration). In addition, we investigated the effect of BPD severity on these measures. Key results: A total of 140 nutritive swallows were analyzed (BPD, n = 92; controls, n = 48). Normal esophageal peristaltic wave patterns were observed in all infants. BPD patients had higher distal contractile esophageal strength compared with controls (Kruskal-Wallis (KW) P = .048), and their deglutitive EGJ relaxation was comparable to controls. Severe BPD patients showed higher bolus distension pressures, higher EGJ resting pressures, and increased EGJ contractile integrals compared with mild BPD patients (Mann-Whitney U P = .009, KW P = .012 and KW P = .028, respectively). Conclusions and Inferences: Preterm infants with BPD consistently present with normal peristaltic esophageal patterns following nutritive liquid swallows. The EGJ barrier tone and relaxation pressure appeared normal. In general, infants with BPD do not have altered esophageal motor function. There is however evidence for increased flow resistance at the EGJ in severe BPD patients possibly related to an increased contractility of the diaphragm.

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“…Contraction in the second segment of the esophagus (proximal portion of smooth muscle esophagus) is present in almost all (pre) term infants, while the first (striated muscle) segment and distal portion of esophagus smooth muscle develop later. However, there are only few data relating to objective esophageal bolus transport parameters during nutritive swallows in preterm infants ( 5 ) and in preterm infants with feeding problems suffering from bronchopulmonary dysplasia (BPD) ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…The aim of this prospective study was to gain more knowledge on esophageal function during nutritive swallows in infants with associated medical pathology. Therefore, HRIM data until currently collected in the Leuven NICU, and in part already reported in infants with BPD, EA, and iCDH were pooled and compared with healthy controls ( 5 , 6 , 13 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

Characterizing Esophageal Motility in Neonatal Intensive Care Unit Patients Using High Resolution Manometry

et al. 2022

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ObjectiveTo characterize esophageal motility and esophago-gastric junction (EGJ) function during feeding in neonatal intensive care unit (NICU) patients.Patients and MethodsHigh resolution manometry with impedance (HRIM) was used to investigate esophageal motility and EGJ function in patients admitted to the NICU. Twenty-eight preterm born infants with bronchopulmonary dysplasia (BPD), 12 born with isolated congenital diaphragmatic hernia (iCDH), and 10 with esophageal atresia (EA) were included. Thirteen healthy infants were included as controls. Esophageal motility and EGJ function were analyzed using objective esophageal bolus transport parameters.ResultsNormal esophageal peristaltic wave patterns were observed in all investigated infants without EA. Nine of 10 patients with EA presented with abnormal esophageal motor wave patterns. A total of 224 nutritive swallows were analyzed (controls, n = 48; BPD, n = 96; iCDH, n = 60; EA, n = 20). Infants with BPD and iCDH had similar distal contractile strength (DCI) compared to healthy controls, while in patients with EA, DCI was significantly lower (Kruskal-Wallis test, p = 0.001). In most infants, EGJ relaxation after swallowing was unaffected. EGJ barrier function, in terms of EGJ-contractile integral, also appeared well-developed and did not differ significantly among patient groups.ConclusionsWe conclude that esophageal motility studies using pressure-impedance analysis are feasible in young infants. Bolus transport mechanisms following nutritive swallows appeared well-established in all investigated infants with the exception of those with EA. EGJ relaxation was also functional after deglutition and EGJ function as an anti-reflux barrier appeared well-developed in all investigated NICU groups.

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Maturation of Esophageal Motility and Esophagogastric Junction in Preterm Infants

Cited by 7 publications

References 32 publications

What is the role of high‐resolution oesophageal manometry in paediatrics?

What is the role of high‐resolution oesophageal manometry in paediatrics?

Characterization of esophageal motility and esophagogastric junction in preterm infants with bronchopulmonary dysplasia

Characterizing Esophageal Motility in Neonatal Intensive Care Unit Patients Using High Resolution Manometry

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