Gastro-oesophageal reflux increases the number of apnoeas in very preterm infants

Abstract

Our data show that a variable rate of apnoeas can be triggered by GER in very preterm infants. Further studies are needed to recognise clinical features that identify those patients who are more susceptible to GER-triggered apnoeas.

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

“…In the last decade, combined esophageal impedance-pH monitoring is the most widely used method for the identification of acid and non-acid reflux [8,10,13,14,20,21]. However, this technology does not detect a substantial part of the acid events in premature infants [14,22].…”

“…Considering the recent evidence that 20-33% of apnea [8,13] and 94.3% of other symptoms present in VLBW infants affected by BPD may have a temporal causal association with reflux episodes, it becomes evident that some newborns may benefit from therapeutic measures [14].…”

“…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 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].…”

Sensibilidade da seriografia do esôfago, estômago e duodeno para o diagnóstico de doença do refluxo gastroesofágico em recém-nascidos prematuros

“…Gastroesophageal reflux disease has also been associated with apparently life-threatening complications such as aspiration pneumonias and apnea, significantly extending the hospital stay of such neonates (2,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13) . Although the longterm esophageal pH monitoring is still considered as the gold standard for the diagnosis of GERD, it presents the disadvantages of an invasive and expensive procedure, besides demanding specialized personnel and equipment, and for these very ciated with digestive and extra-digestive symptoms such as frequent regurgitation and vomiting episodes in association with low weight gain, anemia, esophagitis or respiratory complications (1,2) .…”