Cardiorespiratory events in infants with gastroesophageal reflux symptoms: Is there any association?

• Published in: Neurogastroenterology and motility 2018-05, Vol.30 (5), p.e13278-n/a
• Main Authors: Cresi, F., Martinelli, D., Maggiora, E., Locatelli, E., Liguori, S. A., Baldassarre, M. E., Cocchi, E., Bertino, E., Coscia, A.
• Format: Article
• Language: English
• Subjects: Antacids; Apnea; Bradycardia; Gastroesophageal reflux; Infants; multichannel intraluminal impedance; Neonates; newborn; pH effects; Respiratory system; symptom association probability
• ISSN: 1350-1925; 1365-2982
• DOI: 10.1111/nmo.13278

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