Artículos de revistas
Clinical Predictors Of Abnormal Esophageal Ph Monitoring In Preterm Infants
Registro en:
Arquivos De Gastroenterologia. , v. 45, n. 3, p. 234 - 238, 2008.
42803
10.1590/S0004-28032008000300013
2-s2.0-55249094813
Autor
Mezzacappa M.A.
Rosa A.C.
Institución
Resumen
Background - Risk factors for gastroesophageal reflux disease in preterm neonates have not been yet clearly defined. Aim - To identify factors associated with increased esophageal acid exposition in preterm infants during the stay in the neonatal unit. Methods - A case-control study in preterm infants who had undergone prolonged monitoring of distal esophageal pH, following clinical indication. Eighty-seven preterms with reflux index (percentage of total time of esophageal pHmetry) ≥10% (cases) and 87 unpaired preterms were selected with reflux index <10% (controls). Demographic variables, signs and symptoms, main diagnoses and some aspects of treatment were studied. Simple and multiple logistic regression analysis adjusted for birthweight and postconceptional age at the pH study were used. Results - The factors associated with a greater chance of reflux index ≥10% in preterms were: vomiting, regurgitation, Apnea, female gender. The variables that were associated with a lower frequency of increased reflux index were: volume of enteral intake at the onset of symptoms ≥147 mL/kg/day, and postnatal corticoid use. Conclusions - Vomiting, regurgitation, apnea, female gender and acute respiratory distress during the first week of life were variables predictive of increased esophageal acid exposition in preterm infants with birthweight <2000 g. Bronchopulmonary dysplasia and use of caffeine were not associated with reflux index ≥10%. 45 3 234 238 Akinola, E., Rosenkrantz, T.S., Pappagallo, M., Mckay, K., Hussain, N., Gastroesophageal reflux in infants < 32 weeks gestational age at birth: Lack of relationship to chronic lung disease (2004) Am J Perinatol, 21, pp. 57-62 Ariagno, R.L., Kikkert, M.A., Mirmiran, M., Conrad, C., Baldwin, R.B., Cisapride decreases gastroesophageal reflux in preterm infants (2001) Pediatrics, 107, pp. e58 Ballard, J.L., Khoury, J.C., Wedig, K., Wang, L., Eilers-Walsman, B.L., Lipp, R., New Ballard Score, expanded to include extremely premature infants (1991) J Pediatr, 119, pp. 417-423 Battaglia, F.C., Lubchenco, L.O., A practical classification of newborn infants by weight and gestational age (1967) J Pediatr, 71, pp. 159-163 Blondheim, O., Abbasi, S., Fox, W.W., Buthani, V.K., Effect of enteral gavage feeding rate on pulmonary functions of very low birth weight infants (1993) J Pediatr, 122 (5 PART 1), pp. 751-755 Chin, S.O., Brodsky, N.L., Bhandari, V., Antenatal steroid use is associated with increased gastroesophageal reflux in neonates (2003) Am J Perinatol, 20, pp. 205-213 Davidson, G., The role of lower esophageal sphincter function and dysmotility in gastroesophageal reflux in premature infants and in the first year of life (2003) J Pediatr Gastroenterol Nutr, 37 (SUPPL. 1), pp. s17-s22 Dhillon, A.S., Ewer, A.K., Diagnosis and management of gastro-oesophageal reflux in preterm infants in neonatal intensive care units (2004) Acta Paediatr, 93, pp. 88-93 Donohue, P.K., Baker, S.F., Allen, M.C., Duration of apnea and bradycardia in VLBW infants [abstract] (1997) Pediatrics, 100 (SUPPL.), p. 496 Farhath S, Aghai ZH, Nakhla T, Saslow J, He Z, Soundar S, Mehta DI. Pepsin, a reliable marker of gastric aspiration, is frequently detected in tracheal aspirates from premature ventilated neonates: relationship with feeding and methylxantine therapy. J Pediatr Gastroenterol Nutr. 2006;43:336-41Frakaloss, G., Burke, G., Sanders, M.R., Impact of gastroesophageal reflux on growth and hospital stay in premature infants (1998) J Pediatr Gastroenterol Nutr, 26, pp. 146-150 Grant, L., Cochran, D., Can pH monitoring reliably detect gastro-oesophageal reflux in preterm infants? (2001) Arch Dis Child Fetal Neonatal Ed, 85, pp. F155-F1F7 Herbst, J.J., Minton, S.D., Book, L.S., Gastroesophageal reflux causing respiratory distress and apnea in newborn infants (1979) J Pediatr, 95 (PART 1), pp. 763-768 Hosmer, D.W., Lemeshow, S., (1989) Applied Logistic Regression, , New York: John Wiley; Hrabovsky, E.E., Mullett, M.D., Gastroesophageal reflux and the premature infant (1986) J Pediatr Surg, 21, pp. 583-587 Jadcherla, S.R., Gastroesophageal reflux in the neonate (2002) Clin Perinatol, 29, pp. 135-158 Khalaf, M.N., Porat, R., Brodsky, N.L., Bhandari, V., Clinical correlations in infants in the neonatal intensive care unit with varying severity of gastroesophageal reflux (2001) J Pediatr Gastroenterol Nutr, 32, pp. 45-49 Kimball, A.L., Carlton, D.P., Gastroesophageal reflux medications in the treatment of apnea in premature infants (2001) J Pediatr, 138, pp. 355-360 López-Alonso, M., Moya, M.J., Cabo, J.A., Ribas, J., del Carmen Macías, M., Silny, J., Sifrim, D., Twenty-four-hour esophageal impedance-pH monitoring in healthy preterm neonates: Rate and characteristics of acid, weakly acidic, and weakly alkaline gastroesophageal reflux (2006) Pediatrics, 118, pp. e299-e308 Menon, A.P., Schefft, G.L., Thach, B.T., Apnea associated with regurgitation in infants (1985) J Pediatr, 106, pp. 625-629 Molloy, E.J., Di Fiore, J.M., Martin, R.J., Does gastroesophageal reflux cause apnea in preterm infants? (2005) Biol Neonate, 87, pp. 254-261 Moraes-Filho, J.P., Chinzon, D., Eisig, J.N., Hashimoto, C.L., Zaterka, S., Prevalence of heartburn and gastroesophageal reflux disease in the urban Brazilian population (2005) Arq Gastroenterol, 42, pp. 122-127 Morriss Jr, F.H., Moore, M., Weisbrodt, N.W., West, M.S., Ontogenic development of gastrointestinal motility: IV. Duodenal contractions in preterm infants (1986) Pediatrics, 78, pp. 1106-1113 Nazer, D., Thomas, R., Tolia, V., Ethnicity and gender related differences in extended intraesophageal pH monitoring parameters in infants: A retrospective study (2005) BMC Pediatrics, 5, p. 24 Newell, S.J., Booth, I.W., Morgan, M.E., Durbin, G.M., McNeish, A.S., Gastro-oesophageal reflux in the preterm infants (1989) Arch Dis Child, 64, pp. 780-786 Omari, T.I., Barnett, C.P., Benninga, M.A., Lontis, R., Goodchild, L., Haslam, R.R., Dent, J., Davidson, G.P., Mechanisms of gastro-oesophageal reflux in preterm and term infants with reflux disease (2002) Gut, 51, pp. 475-479 Omari, T.I., Haslam, R.R., Lundborg, P., Davidson, G.P., Effect of omeprazole on acid gastroesophageal reflux and gastric acidity in preterm infants with pathological acid reflux (2007) J Pediatr Gastroenterol Nutr, 44, pp. 41-44 Orenstein, S.R., Tests to assess symptoms of gastroesophageal reflux in infants and children (2003) J Pediatr Gastroenterol Nutr, 37 (SUPPL. 1), pp. s29-s32 Peter, C.S., Sprodowski, N., Bohnhorst, B., Silny, J., Poets, C.F., Gastroesophageal reflux and apnea prematurity: No temporal relationship (2002) Pediatrics, 109, pp. 8-11 Peter, C.S., Wiechers, C., Bohnhorst, B., Silny, J., Poets, C.F., Influence of nasogastric tubes on gastroesophageal reflux in preterm infants: A multiple intraluminal impedance study (2002) J Pediatr, 141, pp. 277-279 Poets, C.F., Gastroesophageal reflux: A critical review of its role in preterm infants (2004) Pediatrics, 113, pp. e128-e132 Shennan, A.T., Dunn, M.S., Ohlsson, A., Lennox, K., Hoskins, E.M., Abnormal pulmonary outcomes in premature infants: Prediction from oxygen requirement in the neonatal period (1988) Pediatrics, 82, pp. 527-532 Thach, B.T., Reflux associated apnea in infants: Evidence for a laryngeal chemoreflex (1997) Am J Med, 103, pp. 120s-124s Vandenplas, Y., Goyvaerts, H., Helven, R., Sacre, L., Gastroesophageal reflux, as measured by 24-hour pH monitoring, in 509 healthy infants screened for risk of sudden infant death syndrome (1991) Pediatrics, 88, pp. 834-840 Vandenplas, Y., Hassall, E., Mechanisms of gastroesophageal reflux and gastroesophageal reflux disease (2002) J Pediatr Gastroenterol Nutr, 35, pp. 119-136 Ward, R.M., Lemons, J.A., Molteni, R.A., Cisapride: A survey of the frequency of use and adverse events in premature newborns (1999) Pediatrics, 103, pp. 469-472