Gastroesophageal Reflux and Cardiorespiratory Problems

Association Between Cardiorespiratory and Gastroesophageal Reflux Events in Infants.

Cardiorespiratory and gastroesophageal reflux events often coexist in infants in Neonatal Intensive Care Unit (NICU) thus leading to drugs over-prescription and delayed discharge.

Through cardiorespiratory and pH-impedance monitoring this study aims to evaluate the temporal association between gastroesophageal reflux (GER) and cardiorespiratory (CR) events in a large number of infants with gastroesophageal reflux disease (GERD) and CR symptoms and, whether this association is significant, to clarify the impact of GER on CR events.

This is an observational retrospective study to describe the association between cardiorespiratory (CR) and gastroesophageal reflux (GER) events in infants who underwent synchronized 24h Multichannel Intraluminal Impedance/pH-metry (MII/pH) and CR monitoring for GER disease symptoms and CR events. Data are collected from medical records and database of the University Neonatal Intensive Care Unit of the Sant'Anna-Regina Margherita Children Hospital (Turin).

The symptom association probability (SAP) index is used to identify those infants with significant associations between GER and CR events. In the group of infants with a positive SAP index the differences in reflux characteristics are compared according to whether a reflux preceded or followed a cardiorespiratory event (30 s time window).

Inclusion Criteria:

• synchronized MII-pH and cardio-respiratory monitoring lasting more than 12 hours, excluding meal periods;
• exclusive enteral feeding
• parents' informed consent

Exclusion Criteria:

• infectious, genetic, metabolic and neurological diseases
• ventilatory support and/or oxygen supplementation at the time of MII-pH/CR monitoring
• pharmacological therapies with effects on GER or apnoea during the week before MII-pH/CR monitoring