Cardiorespiratory events in infants with gastroesophageal reflux symptoms: Is there any association?
Background Cardiorespiratory (CR) events (apnea, bradycardia, oxygen desaturation) and gastroesophageal reflux (GER) symptoms often coexist in infants admitted to Neonatal Intensive Care Unit, leading to over‐prescription of drugs and delayed discharge. We aimed to evaluate the relationships between...
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| Veröffentlicht in: | Neurogastroenterology and motility 2018-05, Vol.30 (5), p.e13278-n/a |
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| creator | Cresi, F. Martinelli, D. Maggiora, E. Locatelli, E. Liguori, S. A. Baldassarre, M. E. Cocchi, E. Bertino, E. Coscia, A. |
| description | Background
Cardiorespiratory (CR) events (apnea, bradycardia, oxygen desaturation) and gastroesophageal reflux (GER) symptoms often coexist in infants admitted to Neonatal Intensive Care Unit, leading to over‐prescription of drugs and delayed discharge. We aimed to evaluate the relationships between CR and GER events.
Methods
The temporal associations between CR and GER events were analyzed in symptomatic infants who underwent synchronized CR and pH‐impedance monitoring. The symptom association probability (SAP) index was used to identify infants with a significant number of temporal associations. Gastroesophageal reflux characteristics and the chronological sequence of CR and GER events occurring within 30 seconds of each other were evaluated according to SAP index.
Key Results
Of the 66 infants enrolled, aged 29 (18‐45) days, 58 had CR events during monitoring. From these 58 patients, a total of 1331 CR events and 5239 GER (24% acidic) were detected. The SAP index was positive in seven (12%) infants. These infants had greater GER frequency, duration, and proximal extent (P |
| doi_str_mv | 10.1111/nmo.13278 |
| format | Article |
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Cardiorespiratory (CR) events (apnea, bradycardia, oxygen desaturation) and gastroesophageal reflux (GER) symptoms often coexist in infants admitted to Neonatal Intensive Care Unit, leading to over‐prescription of drugs and delayed discharge. We aimed to evaluate the relationships between CR and GER events.
Methods
The temporal associations between CR and GER events were analyzed in symptomatic infants who underwent synchronized CR and pH‐impedance monitoring. The symptom association probability (SAP) index was used to identify infants with a significant number of temporal associations. Gastroesophageal reflux characteristics and the chronological sequence of CR and GER events occurring within 30 seconds of each other were evaluated according to SAP index.
Key Results
Of the 66 infants enrolled, aged 29 (18‐45) days, 58 had CR events during monitoring. From these 58 patients, a total of 1331 CR events and 5239 GER (24% acidic) were detected. The SAP index was positive in seven (12%) infants. These infants had greater GER frequency, duration, and proximal extent (P < .05). The number of temporal associations was 10 times greater in the positive SAP group. Gastroesophageal reflux events preceded CR events in 83% of these associations. These GER events had a higher proximal extent (P = .004), but showed no differences in pH values.
Conclusions & Inferences
The simultaneous evaluation of CR and GER events could be useful to identify infants with severe GER and significant temporal associations between these events. Treatment of GER could be indicated in these infants, but as the GER events involved are mainly non‐acidic, empirical treatment with antacids is, often, inappropriate.
Through simultaneous synchronized cardiorespiratory and pH‐impedance monitoring this study clarifies the association between cardiorespiratory and gastroesophageal reflux events in a large number of symptomatic infants. Symptom association probability index was used to identify infants with a significant number of temporal associations between cardiorespiratory and reflux events. In these infants, cardiorespiratory events were preceded by reflux events in 83% of the associations. However, the fact that the refluxes involved were mainly non‐acidic suggest that empiric pharmacological treatment with antacids drugs is, in most cases, inappropriate.</description><identifier>ISSN: 1350-1925</identifier><identifier>EISSN: 1365-2982</identifier><identifier>DOI: 10.1111/nmo.13278</identifier><identifier>PMID: 29266638</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Antacids ; Apnea ; Bradycardia ; Gastroesophageal reflux ; Infants ; multichannel intraluminal impedance ; Neonates ; newborn ; pH effects ; Respiratory system ; symptom association probability</subject><ispartof>Neurogastroenterology and motility, 2018-05, Vol.30 (5), p.e13278-n/a</ispartof><rights>2017 John Wiley & Sons Ltd</rights><rights>2017 John Wiley & Sons Ltd.</rights><rights>Copyright © 2018 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-1abbaca35447cda0f3f9258656f66deea6f5e2f57bb0cad4a8bde58e03432aeb3</citedby><cites>FETCH-LOGICAL-c3538-1abbaca35447cda0f3f9258656f66deea6f5e2f57bb0cad4a8bde58e03432aeb3</cites><orcidid>0000-0002-2139-6855</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fnmo.13278$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fnmo.13278$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29266638$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cresi, F.</creatorcontrib><creatorcontrib>Martinelli, D.</creatorcontrib><creatorcontrib>Maggiora, E.</creatorcontrib><creatorcontrib>Locatelli, E.</creatorcontrib><creatorcontrib>Liguori, S. A.</creatorcontrib><creatorcontrib>Baldassarre, M. E.</creatorcontrib><creatorcontrib>Cocchi, E.</creatorcontrib><creatorcontrib>Bertino, E.</creatorcontrib><creatorcontrib>Coscia, A.</creatorcontrib><title>Cardiorespiratory events in infants with gastroesophageal reflux symptoms: Is there any association?</title><title>Neurogastroenterology and motility</title><addtitle>Neurogastroenterol Motil</addtitle><description>Background
Cardiorespiratory (CR) events (apnea, bradycardia, oxygen desaturation) and gastroesophageal reflux (GER) symptoms often coexist in infants admitted to Neonatal Intensive Care Unit, leading to over‐prescription of drugs and delayed discharge. We aimed to evaluate the relationships between CR and GER events.
Methods
The temporal associations between CR and GER events were analyzed in symptomatic infants who underwent synchronized CR and pH‐impedance monitoring. The symptom association probability (SAP) index was used to identify infants with a significant number of temporal associations. Gastroesophageal reflux characteristics and the chronological sequence of CR and GER events occurring within 30 seconds of each other were evaluated according to SAP index.
Key Results
Of the 66 infants enrolled, aged 29 (18‐45) days, 58 had CR events during monitoring. From these 58 patients, a total of 1331 CR events and 5239 GER (24% acidic) were detected. The SAP index was positive in seven (12%) infants. These infants had greater GER frequency, duration, and proximal extent (P < .05). The number of temporal associations was 10 times greater in the positive SAP group. Gastroesophageal reflux events preceded CR events in 83% of these associations. These GER events had a higher proximal extent (P = .004), but showed no differences in pH values.
Conclusions & Inferences
The simultaneous evaluation of CR and GER events could be useful to identify infants with severe GER and significant temporal associations between these events. Treatment of GER could be indicated in these infants, but as the GER events involved are mainly non‐acidic, empirical treatment with antacids is, often, inappropriate.
Through simultaneous synchronized cardiorespiratory and pH‐impedance monitoring this study clarifies the association between cardiorespiratory and gastroesophageal reflux events in a large number of symptomatic infants. Symptom association probability index was used to identify infants with a significant number of temporal associations between cardiorespiratory and reflux events. In these infants, cardiorespiratory events were preceded by reflux events in 83% of the associations. However, the fact that the refluxes involved were mainly non‐acidic suggest that empiric pharmacological treatment with antacids drugs is, in most cases, inappropriate.</description><subject>Antacids</subject><subject>Apnea</subject><subject>Bradycardia</subject><subject>Gastroesophageal reflux</subject><subject>Infants</subject><subject>multichannel intraluminal impedance</subject><subject>Neonates</subject><subject>newborn</subject><subject>pH effects</subject><subject>Respiratory system</subject><subject>symptom association probability</subject><issn>1350-1925</issn><issn>1365-2982</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp10Mtu1TAQBmCrAtHSsugLVJbYwCKtL7GTdIPQEZdKpd3A2pokkx5XSZx6EkreHh9OywIJy5Jn8enX-GfsVIpzmc7FOIRzqVVRHrAjqa3JVFWqF7vZiExWyhyy10T3QgircvuKHapKWWt1ecTaDcTWh4g0-QhziCvHnzjOxP2Ybge78dHPW34HNMeAFKYt3CH0PGLXL784rcM0h4Eu-RXxeYsROYwrB6LQeJh9GD-csJcd9IRvnt5j9uPzp--br9n17ZerzcfrrNFGl5mEuoYGtMnzomlBdLpLu5fW2M7aFhFsZ1B1pqhr0UCbQ1m3aEoUOtcKsNbH7N0-d4rhYUGa3eCpwb6HEcNCTlZFZYSppE307T_0PixxTNs5JbRMoixkUu_3qomBKH3YTdEPEFcnhdtV71L17k_1yZ49JS71gO1f-dx1Ahd78Oh7XP-f5G6-3e4jfwOKDY_u</recordid><startdate>201805</startdate><enddate>201805</enddate><creator>Cresi, F.</creator><creator>Martinelli, D.</creator><creator>Maggiora, E.</creator><creator>Locatelli, E.</creator><creator>Liguori, S. A.</creator><creator>Baldassarre, M. E.</creator><creator>Cocchi, E.</creator><creator>Bertino, E.</creator><creator>Coscia, A.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2139-6855</orcidid></search><sort><creationdate>201805</creationdate><title>Cardiorespiratory events in infants with gastroesophageal reflux symptoms: Is there any association?</title><author>Cresi, F. ; Martinelli, D. ; Maggiora, E. ; Locatelli, E. ; Liguori, S. A. ; Baldassarre, M. E. ; Cocchi, E. ; Bertino, E. ; Coscia, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-1abbaca35447cda0f3f9258656f66deea6f5e2f57bb0cad4a8bde58e03432aeb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Antacids</topic><topic>Apnea</topic><topic>Bradycardia</topic><topic>Gastroesophageal reflux</topic><topic>Infants</topic><topic>multichannel intraluminal impedance</topic><topic>Neonates</topic><topic>newborn</topic><topic>pH effects</topic><topic>Respiratory system</topic><topic>symptom association probability</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cresi, F.</creatorcontrib><creatorcontrib>Martinelli, D.</creatorcontrib><creatorcontrib>Maggiora, E.</creatorcontrib><creatorcontrib>Locatelli, E.</creatorcontrib><creatorcontrib>Liguori, S. A.</creatorcontrib><creatorcontrib>Baldassarre, M. E.</creatorcontrib><creatorcontrib>Cocchi, E.</creatorcontrib><creatorcontrib>Bertino, E.</creatorcontrib><creatorcontrib>Coscia, A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Neurogastroenterology and motility</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cresi, F.</au><au>Martinelli, D.</au><au>Maggiora, E.</au><au>Locatelli, E.</au><au>Liguori, S. A.</au><au>Baldassarre, M. E.</au><au>Cocchi, E.</au><au>Bertino, E.</au><au>Coscia, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiorespiratory events in infants with gastroesophageal reflux symptoms: Is there any association?</atitle><jtitle>Neurogastroenterology and motility</jtitle><addtitle>Neurogastroenterol Motil</addtitle><date>2018-05</date><risdate>2018</risdate><volume>30</volume><issue>5</issue><spage>e13278</spage><epage>n/a</epage><pages>e13278-n/a</pages><issn>1350-1925</issn><eissn>1365-2982</eissn><abstract>Background
Cardiorespiratory (CR) events (apnea, bradycardia, oxygen desaturation) and gastroesophageal reflux (GER) symptoms often coexist in infants admitted to Neonatal Intensive Care Unit, leading to over‐prescription of drugs and delayed discharge. We aimed to evaluate the relationships between CR and GER events.
Methods
The temporal associations between CR and GER events were analyzed in symptomatic infants who underwent synchronized CR and pH‐impedance monitoring. The symptom association probability (SAP) index was used to identify infants with a significant number of temporal associations. Gastroesophageal reflux characteristics and the chronological sequence of CR and GER events occurring within 30 seconds of each other were evaluated according to SAP index.
Key Results
Of the 66 infants enrolled, aged 29 (18‐45) days, 58 had CR events during monitoring. From these 58 patients, a total of 1331 CR events and 5239 GER (24% acidic) were detected. The SAP index was positive in seven (12%) infants. These infants had greater GER frequency, duration, and proximal extent (P < .05). The number of temporal associations was 10 times greater in the positive SAP group. Gastroesophageal reflux events preceded CR events in 83% of these associations. These GER events had a higher proximal extent (P = .004), but showed no differences in pH values.
Conclusions & Inferences
The simultaneous evaluation of CR and GER events could be useful to identify infants with severe GER and significant temporal associations between these events. Treatment of GER could be indicated in these infants, but as the GER events involved are mainly non‐acidic, empirical treatment with antacids is, often, inappropriate.
Through simultaneous synchronized cardiorespiratory and pH‐impedance monitoring this study clarifies the association between cardiorespiratory and gastroesophageal reflux events in a large number of symptomatic infants. Symptom association probability index was used to identify infants with a significant number of temporal associations between cardiorespiratory and reflux events. In these infants, cardiorespiratory events were preceded by reflux events in 83% of the associations. However, the fact that the refluxes involved were mainly non‐acidic suggest that empiric pharmacological treatment with antacids drugs is, in most cases, inappropriate.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29266638</pmid><doi>10.1111/nmo.13278</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2139-6855</orcidid></addata></record> |
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| ispartof | Neurogastroenterology and motility, 2018-05, Vol.30 (5), p.e13278-n/a |
| issn | 1350-1925 1365-2982 |
| language | eng |
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| source | Wiley Free Content; Wiley Online Library Journals Frontfile Complete |
| subjects | Antacids Apnea Bradycardia Gastroesophageal reflux Infants multichannel intraluminal impedance Neonates newborn pH effects Respiratory system symptom association probability |
| title | Cardiorespiratory events in infants with gastroesophageal reflux symptoms: Is there any association? |
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