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Gastroesophageal reflux in critically ill children: a review

Maria José Solana García1, Jesús López-Herce Cid, César Sánchez Sánchez

  • 1Pediatric Intensive Care Department and Gastroenterology Section, Gregorio Marañón University General Hospital, 28009 Madrid, Spain.

ISRN Gastroenterology
|February 23, 2013
PubMed

Insights

Gastroesophageal reflux (GER) is common in children and critically ill patients. Diagnosis involves pH-metry with impedance, and proton pump inhibitors are the preferred treatment.

Area of Science:

  • Pediatric Gastroenterology
  • Critical Care Medicine

Background:

  • Gastroesophageal reflux (GER) is prevalent in children due to immature antireflux barriers.
  • Critically ill children face increased GER risk from factors like lower esophageal sphincter dysfunction, nasogastric tubes, and mechanical ventilation.

Purpose of the Study:

  • To review the incidence, manifestations, and management of GER in pediatric populations, particularly in critically ill children.

Main Methods:

  • Review of existing literature on pediatric GER, focusing on diagnostic techniques and therapeutic strategies.
  • Emphasis on pH-metry combined with multichannel intraluminal impedance for diagnosis.

Main Results:

  • GER manifests as vomiting and regurgitation in infants, becoming pathological with nutritional impact.
  • In critically ill children, GER can lead to esophageal mucosal damage, hemorrhage, and nosocomial pneumonia from microaspiration.
  • GER in children is predominantly alkaline.

Conclusions:

  • Accurate diagnosis of GER in children, especially the critically ill, relies on pH-metry and impedance.
  • Proton pump inhibitors are recommended for GER treatment due to efficacy, duration, and safety.

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