Reproducibility of 24 hour oesophageal pH studies in infants.

Hampton, F J; MacFadyen, U M; Simpson, Hamish

doi:10.1136/adc.65.11.1249

Cited by 32 publications

(17 citation statements)

References 13 publications

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“…We therefore concur with authors who have alerted pediatricians and pediatrie gastroenterologists to the fact that there is both a misuse and an overuse of pH monitor¬ ing that does not always serve the best interests of infants and children. 16 …”

Section: Resultsmentioning

confidence: 99%

Prolonged pH Monitoring Is of Limited Usefulness for Gastroesophageal Reflux

Ferreira

Lohouès²,

Bensoussan³

et al. 1993

Arch Pediatr Adolesc Med

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Section: Resultsmentioning

confidence: 99%

Prolonged pH Monitoring Is of Limited Usefulness for Gastroesophageal Reflux

Ferreira

Lohouès²,

Bensoussan³

et al. 1993

Arch Pediatr Adolesc Med

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“…Such massive reflux may occur in infants with previously normal pH monitoring, because of the known variability of reflux [6,27]. We recommend that if antireflux therapy can be considered for an infant with cyanotic spells, or apnoeas during sleep, and documented gastro-oesophageal reflux, further investigations be conducted before clinical symptoms are ascribed solely to reflux.…”

Section: Discussionmentioning

confidence: 95%

Lack of temporal relation between acid reflux in the proximal oesophagus and cardiorespiratory events in sleeping infants

et al. 1992

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We studied sleeping infants in order to investigate whether a temporal relation exists between acid reflux extending to the proximal portion of the oesophagus and cardiorespiratory events. One hundred infants with occasional regurgitations were studied: 50 infants admitted after an apparently life-threatening event (ALTE) that occurred during sleep and that remained unexplained despite medical investigation, and 50 asymptomatic infants (non-ALTE). The infants had a median age of 8 weeks (range 4-26 weeks); 54 were boys. In each child a pH probe was placed in the proximal portion of the thoracic oesophagus, under radiological control. Polygraphic monitoring of state of alertness, cardiorespiratory activity, and proximal oesophageal pH changes was conducted continuously during 1 night. The data were analysed blind. In 80 infants a total of 186 decreases in oesophageal pH below 4 units were seen; 37% occurred during wakefulness, and 40% during rapid eye movement (REM) sleep. A total of 7029 central and 61 obstructive apnoeas were monitored, mainly during REM sleep. Within 5 min before, and 5 min after the drops in pH, there was no difference in the number, or the duration of bradycardia, central, mixed, or obstructive apnoea. The infants with an ALTE could not be differentiated from the non-ALTE infants for any of the variables studied. It is concluded that spontaneous acid refluxes extending to the proximal portion of the oesophagus during sleep are usually not temporally related with the development of apnoeas or bradycardias.

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“…Although this latter study is sometimes looked upon as a 'gold standard', its reproducibility has been questioned [3]. The patients in this series were operated on because of severe complications of GER, many with ulcerating oesophagitis, strictures and aspiration.…”

Section: Discussionmentioning

confidence: 99%

Risks and benefits of antireflux operations in neurologically impaired children

et al. 1994

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Gastro-oesophageal reflux (GER) in neurologically impaired children often causes feeding problems and complications of oesophagitis and is frequently resistant to medical treatment. Fifty neurologically impaired children underwent anterior gastropexy as anti-reflux operation, combined with gastrostomy in 23, between 1976 and 1992. There was no operative mortality. There were 25 early complications in 14 patients and 9 late complications in 9 patients. Twelve patients needed 17 re-operations for delayed gastric emptying [4], intestinal obstruction [3], para-oesophageal hernia [3], oesophageal stenosis [4], and recurrent GER, revision of gastrostomy, subphrenic abscess (one each). Nine patients died during the follow up period. Death in two children was related to the operation (incarcerated para-oesophageal hernia and blow-out of the stomach). Out of 41 survivors, the operation was judged successful in 35. It is concluded that antireflux operations in neurologically impaired children carry a high risk of complications. Preoperative identification of risk factors is not possible. The improvements in the quality of life achieved in the majority of patients outweigh the risks.

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Reproducibility of 24 hour oesophageal pH studies in infants.

Cited by 32 publications

References 13 publications

Prolonged pH Monitoring Is of Limited Usefulness for Gastroesophageal Reflux

Prolonged pH Monitoring Is of Limited Usefulness for Gastroesophageal Reflux

Lack of temporal relation between acid reflux in the proximal oesophagus and cardiorespiratory events in sleeping infants

Risks and benefits of antireflux operations in neurologically impaired children

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