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Detection of gastro-oesophageal reflux on the neonatal unit

Research output: Contribution to journalArticle

Thomas Rossor, Ingran Lingam, Abdellah Douiri, Ravindra Bhat, Anne Greenough

Original languageEnglish
JournalActa Paediatrica
Early online date13 Mar 2018
DOIs
StateE-pub ahead of print - 13 Mar 2018

King's Authors

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.

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