Development of Esophageal Peristalsis in Preterm and Term Neonates

Staiano, Annamaria; Boccia, Gabriella; Salvia, G.; Zappulli, D.; Clouse, Ray E.

doi:10.1053/j.gastro.2007.03.042

Cited by 57 publications

(41 citation statements)

References 27 publications

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“…The percentage LES relaxation, an index of the depth of LES relaxation, was calculated as the ratio of the difference between the lowest P LES during LES relaxation and basal P LES over basal P LES . Spontaneous swallows were used for calculation if they met the same timing criterion [12].…”

Section: Methodsmentioning

confidence: 99%

Nasal Continuous Positive Airway Pressure Inhibits Gastroesophageal Reflux in Newborn Lambs

et al. 2014

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BackgroundUsing esophageal pHmetry, nasal CPAP (nCPAP) has been shown to decrease acid gastroesophageal reflux (GER) in adult humans. Although both GER (mainly non-acid) and nCPAP use are very frequent in newborns, the effect of nCPAP on GER in early life is unknown. Having recently shown that the newborn lamb is a unique model for studying neonatal GER, our main objective was to assess the effect of nCPAP on GER in newborn lambs.MethodsEight newborn lambs, aged 2–3 days, were studied. Continuous esophageal pH-Impedance monitoring and polysomnography were performed for six hours during both spontaneous breathing and nCPAP application at 6 cmH2O (nCPAP6), in a randomized order. Results were compared in the two experimental conditions, as well as without CPAP during the following 6 hours.Resultsi) nCPAP6 virtually abolished GER [mean ±SD reflux number for 6 h = 9.1±8.6 without nCPAP6 vs. 0.6±1 with nCPAP6, P<0.05]; ii) GER number was also reduced during the 6 h-period following nCPAP6 application (18±16 without nCPAP6 vs. 7±8.1 with nCPAP6, P<0.05); iii) nCPAP6 decreased the depth and duration of lower esophageal sphincter relaxation.ConclusionsnCPAP inhibits GER in the newborn lamb. Further clinical studies using different levels of nasal CPAP are needed to confirm this result in human infants.

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Section: Methodsmentioning

confidence: 99%

Nasal Continuous Positive Airway Pressure Inhibits Gastroesophageal Reflux in Newborn Lambs

et al. 2014

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“…# 2008 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Using manometry, esophageal motility patterns can be studied and normal motility is now well described in adults (1). However, hardly any data are available on motility patterns in healthy children, with the exception of studies performed in premature infants (2)(3)(4)(5). Gastroesophageal reflux disease (GERD) is by far the most common disease caused by abnormalities in esophageal motility.…”

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confidence: 99%

Role of the Multichannel Intraluminal Impedance Technique in Infants and Children

Wijk

Benninga

Omari

2009

J. pediatr. gastroenterol. nutr.

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Recently, multichannel intraluminal impedance (MII) was added to the repertoire of tests available to study esophageal (patho)physiology in children. MII has since been used in 2 major areas. First, it has been used as a diagnostic test for gastroesophageal reflux disease (GERD). The main advantage over traditional pH monitoring is its ability to detect both acid and nonacid gastroesophageal reflux (GER) and to discern between liquid and gas GER.Although feasible with multiple pH sensors, the MII technique routinely detects the proximal extent of a GER episode. When a pH sensor is added to the MII-catheter, important information about the acidity of a GER event can be gathered.The second area in which the role of MII has been investigated is that of esophageal function testing. Manometry classically reveals information about esophageal pressure patterns and sphincter function, but does not inform us about bolus flow. MII not only detects the presence of esophageal flow but also adds information on the direction of flow, duration of bolus presence, completeness of bolus clearance, and composition of a bolus.The combination of MII with manometry enables determination of the relationship between esophageal pressures and flow and, therefore, enhances evaluation of esophageal function in terms of assessment of mechanisms of esophageal volume clearance. In addition, this technique will improve our understanding of (patho)physiological mechanisms in pediatric GERD and other esophageal motility disorders.

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“…Variable NVP concentrations in infants dosed immediately after birth could result from immature swallowing peristalsis early in life [2]. As NVP concentrations were projected below the 100 ng/ml target at 7 days of age in 80% of infants, our findings combined with other studies [4] suggest that multiple doses of NVP may be needed to achieve protective NVP concentrations.…”

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confidence: 54%

“…When the maternal dose was missed and only the infant received sdNVP, we observed a reduced rate of NVP-resistance compared with the combined maternal–infant regimen [1], indicating lower selective pressure by NVP. We reasoned that incomplete oesophageal peristalsis [2] could expel sdNVP from the mouth with drooling and/or regurgitation of amniotic fluid. We hypothesized that sdNVP absorption would increase with infants’ age at the time of drug administration and measured NVP concentrations in infants first given sdNVP at various times within the first 2 days of life.…”

mentioning

confidence: 99%

Variable and suboptimal nevirapine levels in infants given single-dose nevirapine at birth without maternal prophylaxis

Dross

Rossi

Beck³

et al. 2014

Aids

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Poor access of HIV-1 infected women to prenatal care results in infants receiving singledose (sd) nevirapine (NVP) to prevent mother-to-child-transmission (pMTCT) of HIV-1 without maternal treatment. When the maternal dose was missed and only the infant received sdNVP, we observed a reduced rate of NVP-resistance compared with the combined maternal-infant regimen [1], indicating lower selective pressure by NVP. We reasoned that incomplete oesophageal peristalsis [2] could expel sdNVP from the mouth with drooling and/or regurgitation of amniotic fluid. We hypothesized that sdNVP absorption would increase with infants' age at the time of drug administration and measured NVP concentrations in infants first given sdNVP at various times within the first 2 days of life.Infants treated with sdNVP were enrolled in an observational cohort study conducted in Beira, Mozambique, from June 2005 to July 2008 [1], under the approval of Institutional Review Boards in Seattle and Beira. Specimens for this analysis were selected from infants whose mothers did not take antenatal sdNVP, whose time of birth and administration of 2 mg/kg of sdNVP were recorded, and whose blood was collected 8-40 h after sdNVP ingestion, to reflect the period of absorption but not metabolism of sdNVP [3]. Whole blood specimens collected as dried blood spots (DBS) were used to determine NVP concentrations by liquid chromatography mass spectrometry, with a lower limit of detection of 5 ng/ml, in

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Development of Esophageal Peristalsis in Preterm and Term Neonates

Cited by 57 publications

References 27 publications

Nasal Continuous Positive Airway Pressure Inhibits Gastroesophageal Reflux in Newborn Lambs

Nasal Continuous Positive Airway Pressure Inhibits Gastroesophageal Reflux in Newborn Lambs

Role of the Multichannel Intraluminal Impedance Technique in Infants and Children

Variable and suboptimal nevirapine levels in infants given single-dose nevirapine at birth without maternal prophylaxis

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