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Impedance-pH Measuring in Preterm Infants with Apparently Life-Threatening Events

2007; Lippincott Williams & Wilkins; Volume: 102; Linguagem: Inglês

10.14309/00000434-200709002-01179

1572-0241

Barbara Bizzarri, Giulio Bevilacqua, Fabiola Fornaroli, Nicola de’Angelis, B. Magiteri, Gian Luigi de’Angelis,

Neonatal Respiratory Health Research

Purpose: The aim of the study is to evaluate the diagnostic value of impedance-pH measuring in preterm infants with suspected ALTE (apparently life-threatening events). Methods: Between December 2006 and April 2007, at the Paediatric Gastroenterology Unit of Parma, twenty-four-hour impedance-pH monitoring was performed in 14 preterm infants (3 male- 4 female), hospitalized at Neonatal Intensive Care Unit, University of Parma. The mean age of patients was 28 days with a range between 16–40 days. The MII-pH technique records changes in impedance to alternating current between electrodes caused by the passage of a bolus inside the oesophageal lumen and the changes in pH. A single-use combined MII/pH oesophageal probe, tested and calibrated before each examination, was inserted transnasally. The catheter was comprised of six electrode pairs measuring intraluminal impedance 2–3, 5–5–6, 5–8–9, 5 cm above the LES, and an antimony pH sensor 2 cm above the LES (Sandhill Scientific, Inc; Highlands Ranch, CO). An impedance amplifier delivers current with resulting current flow variations in response to intraluminal impedance changes. The data were stored in an ambulatory recorder and saved on a CompactFlash card. Results: One study was excluded because of technical problems (total recording time 6 hours); a total of 13 infants represents the final patients included, all with a good tolerance of the study. The total recording time was 23.4 ± 1.5 hours. The medium time of the longest episode was 23 minutes (range 4–52 minutes). The median number of reflux events in 24 hours was 73 (range 38–119), with median number of acid reflux 37 (range 20–60) and of non-acid reflux 37 (range 11–62). The majority of reflux was only liquid (90%). The median time of acid exposure of the proximal esophagus (distal channel of impedance probe) was 108 minutes (range 15–277 minutes). Conclusion: Although more studies need to be executed, impedance-ph measuring seems to be a useful diagnostic procedure also in preterm infants. Our results showed that impedance-pH measuring is a useful and safe technique even in infants, althought a normal value for children and infants has not been defined yet and more multicenter studies are necessary to better evaluate and analyze the results, such as the correlation symptoms/reflux.