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Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
06:46

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring

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Esophagitis and modified Bernstein tests in infants with apparent life-threatening events

C A Friesen1, C J Streed, L A Carney

  • 1Department of Gastroenterology, Children's Mercy Hospital, Kansas City, MO 64108.

Pediatrics
|October 1, 1994
PubMed

Insights

Infants with apparent life-threatening events (ALTEs) frequently experience oxygen desaturation during experimental esophageal acidification. Esophagitis is not required for acid sensitivity, and awake ALTEs are linked to positive modified Bernstein tests.

Area of Science:

  • Pediatric Gastroenterology
  • Neonatology
  • Critical Care

Background:

  • Apparent life-threatening events (ALTEs) in infants are a significant clinical concern.
  • The role of esophageal acid exposure in ALTEs requires further elucidation.

Purpose of the Study:

  • To determine the prevalence of abnormal intraesophageal pH monitoring, esophagitis, and oxygen desaturation following experimental esophageal acidification in infants with ALTEs.
  • To investigate the relationship between esophagitis, acid sensitivity, and oxygen desaturation in this population.

Main Methods:

  • Fifty infants admitted with ALTEs were assessed.
  • Methods included 24-hour intraesophageal pH monitoring, esophageal biopsies, and modified Bernstein tests to induce and measure oxygen desaturation during acid perfusion.

Main Results:

  • Abnormal pH monitoring was observed in 82% of patients.
  • Oxygen desaturation (≥5%) occurred in 22% during experimental acidification.
  • Esophagitis was present in 16% and not significantly associated with oxygen desaturation.

Conclusions:

  • Oxygen desaturation during experimental acidification is common in infants with ALTEs and warrants further investigation.
  • Esophagitis is not a prerequisite for esophageal acid sensitivity in infants experiencing ALTEs.
  • ALTEs occurring while awake are frequently associated with a positive modified Bernstein test, indicating acid sensitivity.
Abstract

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