Di Chio T., Chanpong A., Savarino E., et al. Mean Nocturnal Baseline Impedance and Esophageal Chemical Clearance in a Pediatric Population of Patients with Suspected GERD: The Real Add on Value // Neurogastroenterology & Motility. 2019;31(Suppl. 1):e13626
Mean Nocturnal Baseline Impedance and Esophageal Chemical Clearance in a Pediatric Population of Patients with Suspected GERD: The Real Add on Value
T. Di Chio1,3, A. Chanpong3, E. Savarino2, N. Thapar3, E. Salliakellis3, D. Peroni1,
2 University of Padua, Padua
3 Great Ormond Street Hospital for Children, London, UK
Тезисы доклада (Abstracts) на 1-м национальном конгрессе SINGEM
Background and Aim: Mean nocturnal baseline impedance (MNBI) and post-reflux swallowed induced peristaltic wave (PSPW) index are new markers of GERD evaluated during 24-h impedance and pH reflux monitoring. No data are available regarding the MNBI and PSPW index in pediatric population. The aim of this study was to assess MNBI and PSPW index in pediatric patients with GERD related typical and atypical presentation.
Methods: A group of patients with GERD related symptoms was evaluated. All patients underwent upper endoscopy, histology, and impedance monitoring (MII-pH) after a PPI wash-out. All patients were sub-grouped in those with GERD diagnosis (group A) and those without evidence of GERD (group B). GERD was defined as thof at least one of the following parameters: 1. oesophageal mucosal injury at endoscopy; 2. GERD-related histologic abnormalities; 3. abnormal oesophageal acid exposure time (AET > 5%); 4. positive symptom/reflux correlation (positive symptom index and symptom association probability). During MII-pH the values of MNBI and PSPW index were detected according to the recent literature (Frazzoni et al. NMO 2018).
Results: We evaluated 48 pediatric patients with GERD symptoms but only 40 (21 female, mean age 7.9 ± 4.2 yrs; 20 with GERD and 20 without GERD diagnosis) were selected for analysis. Eight patients were excluded: 2 were excluded due to failure of MII-pH recording; 2 with diagnosis of eosinophilic esophagitis; 4 patients performed evaluation on-PPI therapy. Group A was composed of 20 patients (9F) with mean age 7.7 (±4). Seven patients (17.5%) had erosive esophagitis. Mean AET was 14.3 (±20.2), mean reflux number 70.3 (±55.4), only 6 patients had positive symptom/reflux correlation. Group B was composed of 20 patients (12F) with mean age 8 (±3.7). Mean AET 1.6 (±1.5), mean reflux number 34.9 (±25.5), only 2 patients had positive symptom/reflux correlation. Mean AET and number of reflux events were higher in patients from group A ( P < 0.05). Basal impedance values were significantly lower in Group A (834.3 ± 473.3) than in Group B (2608.2 ± 830.9) (P < 0.001). As well, PSPW index was lower in Group A (26.4 ± 18.9) than in group B (48.4 ± 22.1).
Conclusions: According to our results we may suggest that this is the first pilot-study who evaluated MNBI and PSPW index in a pediatric population. Both MNBI and PSPW index showed a very promising results and resulted lower in patients with GERD diagnosis. Future larger studies are needed to detect the cut-off value of both these parameters in a pediatric population as well as their clinical values.
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