Related Experiment Video

Updated: May 11, 2026

Real-Time, Semi-Automated Fluorescent Measurement of the Airway Surface Liquid pH of Primary Human Airway Epithelial Cells
10:18

Real-Time, Semi-Automated Fluorescent Measurement of the Airway Surface Liquid pH of Primary Human Airway Epithelial Cells

Published on: June 13, 2019

Respiratory response to intraesophageal acid infusion in asthmatic children during sleep

R S Davis, G L Larsen, M M Grunstein

    The Journal of Allergy and Clinical Immunology
    |October 1, 1983
    PubMed

    Insights

    In children with nocturnal asthma and acid reflux, nighttime esophageal acid can trigger bronchoconstriction, particularly in those with esophagitis. This effect is more pronounced in the early morning hours.

    Area of Science:

    • Pediatric Pulmonology
    • Gastroenterology
    • Sleep Medicine

    Background:

    • Nocturnal asthma is frequently linked to nighttime gastroesophageal reflux (GER).
    • The direct impact of esophageal acid on bronchoconstriction during sleep remains unclear.

    Purpose of the Study:

    • To investigate if acid in the lower esophagus triggers bronchoconstriction in children with nocturnal asthma and GER.
    • To determine if the timing of acid exposure affects this response.

    Main Methods:

    • Nine children with nocturnal asthma and GER underwent intraesophageal acid (0.1N HCl) and saline infusions during sleep.
    • Patients were grouped based on a positive or negative Bernstein test for esophagitis.
    • Respiratory patterns were monitored using inductance plethysmography, and clinical evaluations were performed.

    Main Results:

    • Acid infusion at midnight had no effect on respiratory patterns or wheezing.
    • Acid infusion between 4 to 5 A.M. induced significant bronchoconstriction and wheezing in all children with a positive Bernstein test.
    • Children with a negative Bernstein test showed no response to acid infusion at any time.

    Conclusions:

    • Lower esophageal acid can trigger bronchoconstriction in asthmatic children with esophagitis during sleep.
    • These children are more susceptible to acid-induced bronchoconstriction in the early morning (4-5 A.M.) compared to midnight.

    More Related Videos

    A Model of Self-limited Acute Lung Injury by Unilateral Intra-bronchial Acid Instillation07:40

    A Model of Self-limited Acute Lung Injury by Unilateral Intra-bronchial Acid Instillation

    Published on: August 30, 2019

    Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring06:46

    Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring

    Published on: December 14, 2020

    Related Concept Videos

    Alterations in Respiration II01:30

    Alterations in Respiration II

    There are numerous types of normal and abnormal respiration. Based on ventilatory movements, breathing patterns are classified as regular, deep, or shallow. Examples include Biot's breathing, Cheyne-Stokes respiration, Kussmaul's breathing, hyperventilation, and hypoventilation. Each pattern is clinically significant and aids in evaluating patients.
    In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes include...
    Respiratory Regulation of Acid-Base Balance01:18

    Respiratory Regulation of Acid-Base Balance

    Respiratory compensation is a vital physiological process that stabilizes blood plasma pH by regulating the partial pressure of carbon dioxide (PCO2), a key determinant of pH levels. Most carbon dioxide in the blood dissolves and converts into carbonic acid (H2CO3). It dissociates into hydrogen ions (H+) and bicarbonate ions (HCO3⁻). There is also an inverse relationship between PCO2​​ and pH.
    When carbon dioxide levels increase in the blood, more H+ and HCO3⁻ are produced, leading to a...
    Acute Respiratory Failure-III01:30

    Acute Respiratory Failure-III

    Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
    Acute Respiratory Failure-IV01:23

    Acute Respiratory Failure-IV

    Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
    Asthma I: Introduction01:28

    Asthma I: Introduction

    Asthma is a chronic inflammatory disorder of the airways characterized by variable airflow obstruction and heightened bronchial responsiveness to a wide range of triggers. The underlying inflammation leads to airway swelling, mucus hypersecretion, and smooth muscle constriction, all of which narrow the airway lumen and impede airflow. Clinically, asthma presents with recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing, symptoms that typically vary in intensity and...
    Asthma III: Clinical Manifestations01:13

    Asthma III: Clinical Manifestations

    Asthma presents with a characteristic pattern of episodic respiratory symptoms that reflect underlying airway inflammation, bronchoconstriction, and mucus hypersecretion. Although severity varies among individuals, certain clinical manifestations are considered hallmarks of the disorder and often guide diagnosis and assessment.Respiratory SymptomsA persistent cough is one of the most common early features of asthma. It is frequently dry and tends to worsen at night or in the early morning,...