Characterization and correction of pressure drift in the ManoScan super((TM)) high-resolution manometry system: In vitro and in vivo

• Published in: Neurogastroenterology and motility 2016-05, Vol.28 (5), p.732-742
• Main Authors: Lamvik, K, Guiu Hernandez, E, Jones, R, Huckabee, M-L
• Format: Article
• Language: English
• ISSN: 1350-1925; 1365-2982
• DOI: 10.1111/nmo.12770

Background A substantial pressure drift in high-resolution manometry (HRM) has been reported; however, fundamental questions remain regarding the origin and management of this drift. The aim of this study was to provide critical in-depth analyses of ManoScan super((TM)) HRM drift in vitro and in vivo. Methods A total of sixteen 15-min studies and twelve 5-h studies were performed in a water bath at 37 degree C at 4.0 cm depth (2.9 mmHg) with ESO and ESO Z catheters. Six 5-h in vitro studies were performed similarly at a depth of 9.0 cm (6.6 mmHg). Eight 15-min studies and nine 8-h in vivo studies were performed with healthy participants. Two correction methods - thermal compensation (TC) and interpolated thermal compensation (ITC) - were tested. Key Results Overall pressure drift varied both between studies (p < 0.01) and within sensors (p < 0.01). Drift resulted from thermal shock, an initial pressure change at intubation, and baseline drift, a linear drift over time (R super(2) > 0.96). Contrary to previous reports, there was no correlation between drift and average (r = -0.02) or maximum pressure exposure (r = -0.05). Following data correction, ITC had the lowest median error but persisted with a maximum error of 2.5 mmHg (IQR = 3.0). Conclusions & Inferences The substantial drift in the ManoScan super((TM)) HRM system is highly variable and not corrected via the standard operating instructions. ITC has superior performance but requires communication with the manufacturer to enable this option. This has a substantial impact on clinical diagnosis, utility of existing normative data, and future research of HRM. The aim of this study was to provide critical in-depth analyses of ManoScan super((TM)) high-resolution manometry pressure drift in vitro and in vivo. Results indicate that the substantial drift in the ManoScan super((TM)) HRM system is highly variable and not corrected via the standard operating instructions.