Gastroesophageal reflux increases the number of apneas in very preterm infants

Corvaglia, Luigi; Zama, Daniele; Gualdi, S.; Ferlini, Marianna; Aceti, Arianna; Mariani, Elisa; Faldella, Giacomo

doi:10.1016/j.dld.2008.07.250

Cited by 3 publications

(5 citation statements)

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“…It has been suggested in experimental models, and recently confirmed also in human studies, a link between GOR and apnoea of prematurity (AOP); 2 it has been also demonstrated that GOR episodes limited to distal oesophagus, which were found in our study to be a great proportion of total GOR, can evoke an apnoea by a reflex mechanisms 16 . For this reason, it is mandatory to optimize the detection of both distal and proximal episodes of acid and non‐acid GOR, in order to better describe the association between GOR and chronic and recurrent respiratory problems of preterm infants.…”

Section: Discussionmentioning

confidence: 87%

“…Gastro‐oesophageal reflux (GOR) is common in preterm infants due to some physiological factors, such as the immaturity of lower oesophageal sphincter (LOS), the supine lying position and the gastric filling with a high volume of fluid 1 . In some patients, GOR can become clinically relevant because it can trigger respiratory phenomena, such as apnoea of prematurity 2 and delay hospital discharge 3 …”

Section: Introductionmentioning

confidence: 99%

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Combined oesophageal impedance‐pH monitoring in preterm newborn: comparison of two options for layout analysis

Corvaglia

Mariani

Aceti

et al. 2009

Neurogastroenterology Motil

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Gastro-oesophageal reflux (GOR) is common in preterm infants. Combined multichannel intraluminal impedance and pH monitoring (pH-MII) is emerging as an useful tool to study both acid and non-acid GOR in this population. We aimed to highlight main advantages and limits of pH-MII in preterm infants and to test whether the inclusion of GOR episodes detected only by pH monitoring details better the features of GOR. Fifty-two symptomatic preterm infants underwent a 24-hour, continuous and simultaneous measurement of pH-MII. Each layout was analyzed using two different options: option 1 included GOR episodes detected by MII and then classified as acid or non-acid according to the associated pH change; option 2 included GOR episodes detected by MII and also GOR episodes detected only by pH sensor. By adopting option 1, a total number of 2834 GOR episodes was detected by MII: 2162 of them were characterized as non-acid and 672 were characterized as acid. The median (range) number of acid MII-GOR episodes was 10 (1-52); the median (range) number of non-acid MII-GOR episodes was 36.5 (2-119). Median (range) acid MII-GOR-bolus exposure index was 0.28% (0.02-2.73%); median (range) non-acid MII-GOR-bolus exposure index was 1.03% (0.06-38.15%). By adopting option 2, an average of 53.2 acid GOR episodes and an average of 11% oesophageal exposure to acid GOR more than by option 1 was detected. An accurate and detailed description of GOR in preterm infants can be obtained only by including in the analysis all acid GOR episodes detected by pH sensor.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Combined oesophageal impedance‐pH monitoring in preterm newborn: comparison of two options for layout analysis

Corvaglia

Mariani

Aceti

et al. 2009

Neurogastroenterology Motil

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“…Other studies describe some of these symptoms as not so common/more rare, like difficulty gaining weight/failure to thrive, desaturation, "choking", "gagging", chewing, refusing to eat, irritability, showing discomfort, grimacing, and arching, cough, yawning, hiccups and sneezing [41,42]. Some studies stated that GERD and premature apnea is common in premature infants and seem to be timely related to each other, which would mean that occasions of reflux can trigger apnea in premature infants [43][44][45]. Other studies describe both apnea, bradycardia, desaturations and GERD are common in premature infants, but with few exceptions, there is no evidence for a fixed relationship between them [46,47].…”

Section: Specific Symptoms Of Gerd In Premature Infantsmentioning

confidence: 99%

“…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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“…Mas, se considerarmos as informações disponíveis, pelo menos parte destes sintomas (20-30%) pode ter associação com episódios de RGE e estes RN poderiam se beneficiar de medidas terapêuticas 48,60,61 Se acontecerem complicações como apneias muito importantes (pausas muito demoradas na respiração) o exame será suspenso.…”

Section: Discussionunclassified

Monitorização prolongada do pH esofágico em recém-nascidos com menos de 1500 gramas com e sem displasia broncopulmonar

Mendes¹

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Gastroesophageal reflux increases the number of apneas in very preterm infants

Cited by 3 publications

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Combined oesophageal impedance‐pH monitoring in preterm newborn: comparison of two options for layout analysis

Combined oesophageal impedance‐pH monitoring in preterm newborn: comparison of two options for layout analysis

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

Monitorização prolongada do pH esofágico em recém-nascidos com menos de 1500 gramas com e sem displasia broncopulmonar

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