Prognostic Values of Multichannel Intraluminal Impedance and pH Monitoring in Newborns with Symptoms of Gastroesophageal Reflux Disease

Cresi, Francesco; Locatelli, Emanuela; Marinaccio, C; Grasso, Giulia; Coscia, Alessandra; Bertino, Enrico

doi:10.1016/j.jpeds.2012.10.009

Cited by 22 publications

(30 citation statements)

References 27 publications

(13 reference statements)

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“…Previous results have shown that acid refluxes are present in infants, even in newborns, and suggest they are responsible for pathological consequences, including laryngitis (Cresi et al, 2013;Jadcherla et al, 2011;López-Alonso et al, 2006;Shin et al, 2012;Vermeylen et al, 2005). However, our results may not apply to reflux laryngitis secondary to weakly acid reflux, which are especially prominent in newborns.…”

Section: Reflux Laryngitis Modelcontrasting

confidence: 58%

Effects of reflux laryngitis on non-nutritive swallowing in newborn lambs

Brisebois¹,

Samson²,

Fortier³

et al. 2014

Respiratory Physiology & Neurobiology

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Reflux laryngitis in infants may be involved not only in laryngeal disorders, but also in disorders of cardiorespiratory control through its impact on laryngeal function. Our objective was to study the effect of reflux laryngitis on non-nutritive swallowing (NNS) and NNS-breathing coordination. Two groups of six newborn lambs, randomized into laryngitis and control groups, were surgically instrumented for recording states of alertness, swallowing and cardiorespiratory variables without sedation. A mild to moderate reflux laryngitis was induced in lambs from the experimental group. A significant decrease in the number of NNS bursts and apneas was observed in the laryngitis group in active sleep (p = 0.03).In addition, lower heart and respiratory rates, as well as prolonged apnea duration (p < 0.0001) were observed. No physiologically significant alterations in NNS-breathing coordination were observed in the laryngitis group. We conclude that a mild to moderate reflux laryngitis alters NNS burst frequency and autonomous control of cardiac activity and respiration in lambs. ABSTRACTReflux laryngitis in infants may be involved not only in laryngeal disorders, but also in disorders of cardiorespiratory control through its impact on laryngeal function. Our objective was to study the effect of reflux laryngitis on non-nutritive swallowing (NNS) and NNS-breathing coordination. Two groups of six newborn lambs, randomized into laryngitis and control groups, were surgically instrumented for recording states of alertness, swallowing and cardiorespiratory variables without sedation. A mild to moderate reflux laryngitis was induced in lambs from the experimental group. A significant decrease in the number of NNS bursts and apneas was observed in the laryngitis group in active sleep (p = 0.03).In addition, lower heart and respiratory rates, as well as prolonged apnea duration (p < 0.0001) were observed. No physiologically significant alterations in NNS-breathing coordination were observed in the laryngitis group. We conclude that a mild to moderate reflux laryngitis alters NNS burst frequency and autonomous control of cardiac activity and respiration in lambs.

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Section: Reflux Laryngitis Modelcontrasting

confidence: 58%

Effects of reflux laryngitis on non-nutritive swallowing in newborn lambs

Brisebois¹,

Samson²,

Fortier³

et al. 2014

Respiratory Physiology & Neurobiology

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“…A reflux reaching the two most proximal channels is defined as proximal. pH‐GER events, defined as drop of pH value below 4 longer than 5 seconds and not associated with a MII‐GER event, were considered in the analysis as well …”

Section: Methodsmentioning

confidence: 99%

“…Each MII‐GER event was defined as weakly acidic (4 ≤ pH > 7), acidic (pH <4), or weakly alkaline (pH ≥7) according to the minimum pH value reached during each event …”

Section: Methodsmentioning

confidence: 99%

Cardiorespiratory events in infants with gastroesophageal reflux symptoms: Is there any association?

Cresi

Martinelli

Maggiora

et al. 2017

Neurogastroenterology Motil

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“…The diagnostic power of combined MII and 24-hour pH monitoring in detecting all refluxes and acid refluxes in infants were statistically higher than pH monitoring alone in children older than one year. Adding the MII to 24-hour pH monitoring method increased the accuracy of the detection of reflux events (4,8) . There was a relationship between reflux and atypical symptoms, particularly respiratory ones and also regardless of age and the relationship between reflux and atypical symptoms in infants less than one year of age (5) .…”

Section: Resultsmentioning

confidence: 99%

Combined 24-Hours Esophageal Ph Monitoring and Multichannel Intraluminal Impedance for Comparison of Gastroesophageal Reflux in Children With Typical Versus Atypical Symptoms of Gastroesophageal Reflux Disease

Dehghani

Taghavi

Javaherizadeh

et al. 2016

Arq. Gastroenterol.

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-Background -Gastroesophageal reflux disease is the most common esophageal disorder in pediatrics.Objective -The aim of this study was to compare reflux parameters of typical and atypical symptoms of gastroesophageal reflux disease using 24-hour esophageal pH monitoring and multichannel intraluminal impedance in pediatric population. Methods -In this prospective study, 43 patients aged less than 18 year with suspected gastroesophageal reflux disease were enrolled. The patients were divided into two groups based on the main presenting symptoms (typical versus atypical). Twenty four-hour pH monitoring and multichannel intraluminal impedance were performed in all the patients for comparing these two group regarding association of symptoms and reflux. Number of refluxes, pH related reflux, total reflux time, reflux more than 5 minutes, longest time of the reflux, lowest pH at reflux, reflux index were recorded and compared. Data comparison was done using SPSS.Results -The mean age of the patients was 5.7±3.4 years and 65.1% were male. Out of 43 patients 24 cases had typical symptoms and 19 had atypical symptoms. The mean reflux events detected by multichannel intraluminal impedance was more than mean reflux events detected by pH monitoring (308.4±115.8 vs 69.7±66.6) with P value of 0.037, which is statistically significant. The mean symptom index and symptom association probability were 35.01% ± 20.78% and 86.42% ± 25.79%, respectively in multichannel intraluminal impedance versus 12.73% ± 12.48% and 45.16% ± 42.29% in pH monitoring (P value <0.001). Number of acid reflux was 46.26±47.16 and 30.9±22.09 for atypical and typical symptoms respectively. The mean symptom index was 18.12% ± 13.101% and 8.30% ± 10.301% in atypical and typical symptoms respectively (P=0.034). Bolus clearance was longer in atypical symptoms compared typical symptoms(P<0.05). Conclusion -Symptom index was significantly higher in atypical symptoms compared to typical symptoms. Higher number of acid reflux was found in children with atypical symptoms of reflux. Longer duration of bolus clearance was found in group with atypical symptoms of reflux.

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Prognostic Values of Multichannel Intraluminal Impedance and pH Monitoring in Newborns with Symptoms of Gastroesophageal Reflux Disease

Cited by 22 publications

References 27 publications

Effects of reflux laryngitis on non-nutritive swallowing in newborn lambs

Effects of reflux laryngitis on non-nutritive swallowing in newborn lambs

Cardiorespiratory events in infants with gastroesophageal reflux symptoms: Is there any association?

Combined 24-Hours Esophageal Ph Monitoring and Multichannel Intraluminal Impedance for Comparison of Gastroesophageal Reflux in Children With Typical Versus Atypical Symptoms of Gastroesophageal Reflux Disease

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