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Endoluminal Functional Lumen Imaging Probe Is Safe in Children Under Five Years Old
Brett Hoskins1, Erik Almazan2, Douglas Mogul1
1The Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, The Johns Hopkins University School of Medicine.
Insights
The Endoluminal functional lumen imaging probe (EndoFLIP) is safe for children under 5 years old, showing similar procedure times and no complications compared to older children. This novel device aids in diagnosing esophageal disorders in young patients.
Area of Science:
- Pediatric Gastroenterology
- Medical Device Technology
- Esophageal Diagnostics
Background:
- The Endoluminal functional lumen imaging probe (EndoFLIP) is a novel, minimally invasive device utilizing high-resolution impedance planimetry for diagnosing esophageal disorders.
- The US Food and Drug Administration (FDA) has approved EndoFLIP for use in children aged 5 years and older.
- This study aimed to evaluate the safety and luminal characteristics of EndoFLIP in children younger than 5 years compared to those 5 years and older.
Purpose of the Study:
- To assess the safety and efficacy of the Endoluminal functional lumen imaging probe (EndoFLIP) in children under 5 years of age.
- To compare procedural outcomes and luminal characteristics of EndoFLIP between pediatric patients younger than 5 years and those 5 years or older.
- To determine the utility of EndoFLIP in managing esophageal disorders in very young children.
Main Methods:
- A single-center, retrospective review of patients under 21 years of age who underwent esophagogastroduodenoscopy (EGD) with EndoFLIP between October 2017 and November 2020.
- Patients were divided into two groups: those under 5 years of age and those 5 years of age or older.
- Procedure times, adverse events, and lower esophageal sphincter (LES) pressure at 30 mL inflation were analyzed.
Main Results:
- Sixty-seven EGDs with EndoFLIP were performed in 56 patients (14 in children <5 years, 53 in children ≥5 years).
- Median procedure times were similar between the groups (32 min vs. 28 min, P=0.08).
- No adverse events or unplanned hospitalizations occurred in either group. A statistically significant difference in LES pressure at 30 mL inflation was observed between the two age groups (P=0.02).
Conclusions:
- Endoluminal functional lumen imaging probe (EndoFLIP) demonstrates safety in a cohort of children younger than 5 years.
- The device appears to be a valuable tool for managing esophageal disorders in this younger pediatric population.
- No significant differences in procedure time or complications were noted between the age groups, supporting its use across a wider pediatric range.
Background:
Endoluminal functional lumen imaging probe (EndoFLIP) is a minimally invasive, novel device that uses high-resolution impedance planimetry to measure important parameters of the gastrointestinal lumen that aid in the diagnosis of esophageal disorders. EndoFLiP is approved by the US Food and Drug Administration (FDA) for children 5 years and older. We sought to compare its safety and luminal characteristics between children under 5 years of age with children 5 years and older.
Methods:
A single-center retrospective review was performed to identify all patients < 21 years of age who underwent esophagogastroduodenoscopy (EGD) with EndoFLIP between October 2017 and November 2020. Results: Sixty-seven EGDs with EndoFLIP were performed in 56 patients, including 14 that were done in children < 5 years and 53 in children ≥5years. The median age in the < 5-year group was 1.7years (interquartile range [IQR], 0.9-4.4) and the youngest patient was 1 month old. The median age in ≥5-year group was 14.3 years (IQR, 8.2-16.2). Median procedure times were similar (32 minutes [IQR, 25-48] for the < 5-year group; 28 minutes [IQR, 20-33] for ≥5-year group; P = 0.08). There were no adverse events or unplanned hospitalizations in either group. At 30 mL inflation, the pressure of the lower esophageal sphincter (LES) was statistically different between the 2 groups (P = 0.02).
Conclusion:
EndoFLIP appears to be safe for use in our small cohort of children < 5 years of age and may be an important tool in the management of esophageal disorders in this age group. There was no difference in procedure time between our 2 age groups and there were no procedure-related complications.
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