Detection of gastro‐oesophageal reflux in the neonatal unit |
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| Authors: | Thomas Rossor Ingran Lingam Abdel Douiri Ravindra Bhat Anne Greenough |
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| Institution: | 1. MRC Centre in Allergic Mechanisms of Asthma, King's College London, London, UK;2. Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK;3. Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK;4. Department of Primary Care and Public Health Sciences, King's College London, London, UK;5. NIHR Biomedical Research Centre, Guy's and St Thomas’ NHS Foundation Trust, King's College London, London, UK |
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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 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 post‐natal 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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| Keywords: | Baseline oesophageal impedance Multichannel intraluminal impedance pH study |
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