Autonomic function, gastroesophageal reflux in apparent life threatening event

Tirosh, Emanuel; Ariov-Antebi, Noga; Cohen, Ayala

doi:10.1007/s10286-010-0054-x

Cited by 9 publications

(4 citation statements)

References 28 publications

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“…This change was mainly due to a decrease in parasympathetic activity (as evidenced by the decrease in SDSD, RMSSD, HF and HF nu ). The present results support and extend the Tirosh et al's hypothesis [8] whereby autonomic alterations are associated with GER. The latter authors have shown that infants with a history of idiopathic, apparently life-threatening events display a significant HRV increase in the period preceding obstructive apnea.…”

Section: Discussionsupporting

confidence: 92%

“…It has further been hypothesized that disturbances in ANS activity could impair contraction of the lower esophageal sphincter (which normally acts as a reflux barrier) and may be involved in transient lower esophageal sphincter relaxation (and therefore also GER) [6,7]. Lastly, it has been suggested that ANS changes have a role in GER in neonates [8]. …”

Section: Introductionmentioning

confidence: 99%

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Involvement of Autonomic Nervous Activity Changes in Gastroesophageal Reflux in Neonates during Sleep and Wakefulness

et al. 2013

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BackgroundIt has been suggested that disturbed activity of the autonomic nervous system is one of the factors involved in gastroesophageal reflux (GER) in adults. We sought to establish whether transient ANS dysfunction (as assessed by heart rate variability) is associated with the occurrence of GER events in neonates during sleep and wakefulness.MethodsNineteen neonates with suspected GER underwent simultaneous, synchronized 12-hour polysomnography and esophageal multichannel impedance-pH monitoring. We compared changes in HRV parameters during three types of periods (control and prior to and during reflux) with respect to the vigilance state.ResultsThe vigilance state influenced the distribution of GER events (P<0.001), with 53.4% observed during wakefulness, 37.6% observed during active sleep and only 9% observed during quiet sleep. A significant increase in the sympathovagal ratio (+32%, P=0.013) was observed in the period immediately prior to reflux (due to a 15% reduction in parasympathetic activity (P=0.017)), relative to the control period. This phenomenon was observed during both wakefulness and active sleep.ConclusionOur results showed that GER events were preceded by a vigilance-state-independent decrease in parasympathetic tone. This suggests that a pre-reflux change in ANS activity is one of the factors contributing to the mechanism of reflux in neonates.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Involvement of Autonomic Nervous Activity Changes in Gastroesophageal Reflux in Neonates during Sleep and Wakefulness

et al. 2013

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“…The adaptation to extra-uterine life is a slow and difficult process for these babies because of their prematurity. At this critical period, hypothermia, apnoea, respiratory distress, and cardiac instabilities such as bradycardia and hypotension are common features in these newborn babies (Bhatt et al, 2010;Di Fiore et al,2001;Dransfield et al, 1983;Tirosh et al, 2010;Trevisanuto et al, 2005;Upton, et al, 1992), and the resulting hypoxia may lead to brain damage and cardiac arrest if the medical support of a special incubator equipped with a ventilator and systemic monitoring is not provided a as a "primary life support system". Therefore, the continuous monitoring of heartbeat, respiration, oxygen saturation, blood pressure and temperature has been integrated into the neonatal intensive care unit (NICU) as a mandatory tool to support the fragile clinical conditions of these infants.…”

Section: Introductionmentioning

confidence: 99%

The Emergence and Development of Physiological Regulatory Systems of Newborn Infants in a Neonatal Intensive Care Unit

Bonno¹,

Begum²,

Yamamoto³

2012

Advances in Electrocardiograms - Clinical Applications

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“…Five studies were conducted in Israel, by Ari, Tirosh, Weiss, Tirosh and Goldhammer concluding to excellent prognosis among BRUE and ALTE patients and a low-yield of performed tests, with a raised possibility of an abnormality in the autonomic function related to apnea and Gastro-Esophageal Reflux (GER). 11,[17][18][19][20] Similarly, two studies underwent in Iran by Aminiahidashti and Kadivar found, respectively, a predominance of gastric etiologies and an increased incidence of 11‰ with 18 patients admitted for ALTE. 21,22 The goal of this study was to retrieve the epidemiologic characteristics of infants admitted for BRUE in Lebanon, as well as the final diagnosis and the therapeutic management.…”

mentioning

confidence: 99%

Brief resolved unexpected event: prevalence, etiology and epidemiologic characteristics in Lebanon. a retrospective study of hospitalizations in a tertiary-care center

Antoun¹,

Sabbagh²

2020

JPNC

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Objective: A Brief Resolved Unexplained Event (BRUE) is a common condition in infancy. However, no epidemiological study has been undergone in Lebanon. This study aims to establish the prevalence and the characteristics of the population hospitalized after a BRUE. Material and methods: A single-center retrospective study performed from 1998 to 2018 included 156 hospitalized infants, aged less than one year old, in a tertiary medical center. Data were collected from hospital archives. Results: Most infants (92.9%) hospitalized after a BRUE were aged less than 6 months old, with a slight masculine predominance (52.6%). No pathognomonic symptom was identified. In terms of recurrence of the initial episode, it occurred in 55.1% of the cases. A transfer to a reanimation unit took place in 35.9% of patients, with an average stay of 6.3 days. Two infants were deceased and six were readmitted for the same chief complaint. Final confirmed diagnosis was a Gastro-Esophageal Reflux (GER) in 60.9%. Consequently, a milk change occurred in 17.9% and a GER treatment in 65.4%. Conclusion: Infants younger than one year and hospitalized for a BRUE present a majority of confirmed GER diagnosis, and seem to have an excellent prognosis.

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Autonomic function, gastroesophageal reflux in apparent life threatening event

Abstract: Infants with history of IALTE and GER have a significant abnormality in their autonomic control that is marked in the coupled events of apnea and GER. This finding is possibly related to medullary autonomic regulation.

Cited by 9 publications

References 28 publications

Involvement of Autonomic Nervous Activity Changes in Gastroesophageal Reflux in Neonates during Sleep and Wakefulness

Involvement of Autonomic Nervous Activity Changes in Gastroesophageal Reflux in Neonates during Sleep and Wakefulness

The Emergence and Development of Physiological Regulatory Systems of Newborn Infants in a Neonatal Intensive Care Unit

Brief resolved unexpected event: prevalence, etiology and epidemiologic characteristics in Lebanon. a retrospective study of hospitalizations in a tertiary-care center

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