Clinical Correlations in Infants in the Neonatal Intensive Care Unit With Varying Severity of Gastroesophageal Reflux

Mn, Khalaf; Porat, Rachel; Nl, Brodsky; Bhandari,

doi:10.1097/00005176-200101000-00014

Cited by 51 publications

(43 citation statements)

References 21 publications

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“…However, because of the gestational age established for study inclusion, these events occurred in most of these subjects. In addition, the low gestational age contributed to the presence of respiratory failure in the first week of life, which in turn is a risk factor for high RI [30,31]. Likewise, the minimum chronological age of 28 days, in order to standardize the postmenstrual age among groups [17], hindered the inclusion of healthy newborns in the group that did not present BPD, due to a shorter hospital stay.…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Esophageal Acid Exposure in Very Low Birth Weight Infants Presenting or Not Bronchopulmonary Dysplasia: A Prospective Cross-Sectional Study

Mezzacappa¹

2014

J Neonatal Biol

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IntroductionBronchopulmonary dysplasia (BPD) affects about 22% of very low birth weight (VLBW) newborns [1]. The disease has a turbulent clinical course, significantly contributing to morbidity and mortality in the neonatal period, and leaving long-term sequelae [2].The frequency of Gastroesophageal Reflux (GER) causing symptoms and a complicated clinical course in premature infants presenting BPD during their stay in neonatal care units is not fully established [3][4][5] and widely questioned.Although there is experimental and clinical evidence that sleep apnea occurs as a result of reflux episodes [6,7], the cause-effect relation between the conditions is controversial [8][9][10]. Similarly there is disagreement regarding the effects of GER in the pathogenesis and in BPD recovery [5,11]. The presence of pepsin in the tracheal aspirate in ventilated newborns during the first weeks of life, and the subsequent progression to BPD in these newborns may indicate the possibility of chronic aspiration as a mechanism in the genesis of BPD [12]. Furthermore, there is evidence that symptoms associated with acid reflux episodes that reach or not the pharynx, if cleared slowly, are common in newborns presenting BPD on respiratory support [13,14].Despite the controversies, the presumptive diagnosis of GER has been quite frequent in neonatal units in North America, and there is indication that 24.8% of VLBW infants are treated for the condition [15]. Treatment is even more common (47.6%) among VLBW infants who are discharged after 42 weeks of postmenstrual age, of which 75.7% have DBP [15].Given the uncertainty regarding the occurrence of GER in newborns presenting BPD and the frequency of GER treatment, the prospective study of distal esophagic pH monitoring (DEpHM) abnormalities in newborn infants presenting or not BPD was considered. AbstractBackground: A high frequency of treatment for gastroesophageal reflux disease is observed in neonates with Bronchopulmonary Dysplasia (BPD). The association between these illnesses is controversial.

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Section: Discussionmentioning

confidence: 99%

High Prevalence of Esophageal Acid Exposure in Very Low Birth Weight Infants Presenting or Not Bronchopulmonary Dysplasia: A Prospective Cross-Sectional Study

Mezzacappa¹

2014

J Neonatal Biol

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“…In these patients, fundoplication and gastric diversion can help to improve lung function. As already underlined by the NASPGAN guidelines [7,14], early aggressive treatment should be recommended when reflux is confirmed in order to prevent lifethreatening events and lung damage that can lead to asthma or pulmonary destruction due to infection and bronchiectasis development.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, other studies underline the importance of the early diagnosis of GER and of aggressive management, which may decrease neonatal morbidity and result in earlier discharge from the NICU [7].…”

mentioning

confidence: 96%

European multicenter survey on the laparoscopic treatment of gastroesophageal reflux in patients aged less than 12 months with supraesophageal symptoms

et al. 2005

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“…The most common symptoms of GERD were: apnea, bradycardia, desaturation, frequent regurgitation, "gagging", chewing, vomiting, low food intake, difficulties with eating, some intolerance of food and difficulty gaining weight/failure to thrive [32][33][34][35][36]. Other frequently documented symptoms of GERD were: coughing, "grunting" (labored breathing), recurrent attacks with cyanosis, arching, grimacing, crying, showing signs of irritability, discomfort and pain, and stretching out extremities [37][38][39][40].…”

Section: Specific Symptoms Of Gerd In Premature Infantsmentioning

confidence: 99%

“…GERD is considered common in premature infants younger than 34 weeks gestational age, but the severity of GERD is not significantly different in symptomatic and asymptomatic infants [37,40,50]. Some authors stated that GERD is common even in premature infants younger than 32 weeks gestational age [33,34,36,41,44]. Infants with recurrent apnea have been studied at different ages, where gestational age at birth varied between 24-36 weeks and the studies have been conducted when the infants were 7-32 days old [32,43,[46][47][48].…”

Section: The Age Of the Premature Child When The Pattern Of Gerd Can mentioning

confidence: 99%

Development of an Observational Instrument to Assess Gastro-Esophageal Reflux Disease in Premature Infants

Sandberg

Öhman

2014

Int. J. Child Health Nutr.

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Background: Premature infants are at increased risk of developing Gastroesophageal Reflux Disease (GERD), which for these children is associated with a number of severe symptoms. There is great need for effective instruments and clear symptom criteria to assess the presence and degree of severity of GERD. Aim: To develop and pilot test an observation instrument for early detection of symptoms of GERD in premature infants. Method: A combination of three research methods was used – systematic literature review, observation instrument development and a pilot test. Results: The systematic review identified specific symptoms of GERD. The development of the observational instrument started with the establishment of concordance between the criteria of symptoms according to the literature review and to NIDCAP, “Newborn Individualized Developmental Care and Assessment Program”. In the pilot test the criteria of symptoms were revised by comparing the result and the criteria between infants that clinically were estimated to have had a reflux problem and the ones who did not. Conclusion: An observation instrument was developed. The clinical evaluation by a pilot test showed that the instrument could be useful to record significant symptoms and combinations of symptoms that may occur in premature infants assessed as having reflux problems.

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Clinical Correlations in Infants in the Neonatal Intensive Care Unit With Varying Severity of Gastroesophageal Reflux

Cited by 51 publications

References 21 publications

High Prevalence of Esophageal Acid Exposure in Very Low Birth Weight Infants Presenting or Not Bronchopulmonary Dysplasia: A Prospective Cross-Sectional Study

High Prevalence of Esophageal Acid Exposure in Very Low Birth Weight Infants Presenting or Not Bronchopulmonary Dysplasia: A Prospective Cross-Sectional Study

European multicenter survey on the laparoscopic treatment of gastroesophageal reflux in patients aged less than 12 months with supraesophageal symptoms

Development of an Observational Instrument to Assess Gastro-Esophageal Reflux Disease in Premature Infants

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