Detection of gastro-oesophageal reflux on the neonatal unit

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Abstract

Aim To determine whether a pH probe or multichannel intraluminal impedance (MII) more frequently detected gastro-oesophageal reflux and test the hypothesis that acid reflux was associated with lower baseline impedance. Methods A prospective study of infants in whom reflux was suspected and evaluated using combined pH and multichannel impedance. Studies were considered abnormal if the acid index was >10% or there were > 79MII reflux events in 24 hours. The acid index was the percentage of total study time with a pH<four and the acid clearance time (ACT) the time from the pH falling below four to rising above four. Results Forty-two infants (median gestational age 31 (range 23-42) weeks) were assessed. Only nine infants (21%) had abnormal studies, seven detected by pH monitoring, one by MII monitoring and one by both techniques (p=0.04). After correcting for gestational age and postnatal age, baseline impedance remained negatively correlated with the acid index (r=-0.34, p=0.038) and the maximum ACT (r=-0.44, p=0.006) Conclusion Clinical suspicion of reflux was frequently incorrect and reflux was more frequently detected by a pH probe. The inverse relationship of acid reflux to baseline impedance suggests that mucosal disruption may result from acid reflux in this population.
Original languageEnglish
JournalActa Paediatrica
Early online date13 Mar 2018
DOIs
Publication statusE-pub ahead of print - 13 Mar 2018

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