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Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e3181fa06d7
Original Articles: Gastroenterology

Temporal Association of Polysomnographic Cardiorespiratory Events With GER Detected by MII-pH Probe in the Premature Infant at Term

Nunez, Jeanne*; Cristofalo, Elizabeth*; McGinley, Brian; Katz, Richard; Glen, Daniel R§; Gauda, Estelle*



Figure 2 reproduced incorrectly in the May 2011 issue of the journal. The correct presentation is as follows:

Journal of Pediatric Gastroenterology and Nutrition. 52(6):787, June 2011.

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Objectives: The aim of the study was to examine temporal association (TA) between polysomnographic cardiorespiratory (CR) events and gastroesophageal reflux (GER) in premature infants with persistent CR events at >39 weeks postmenstrual age and determine whether the use of multichannel intraluminal impedance (MII)-pH probe improves sensitivity of the TA compared with pH probe alone.

Patients and Methods: Seven infants born between 24 and 29 weeks' gestational age with persistent CR events at 39 to 48 weeks' postmenstrual age underwent a polysomnography with MII-pH probe. Symptom index (SI) and symptom-associated probability were calculated for diverse types of reflux and CR events. SI and a Fisher exact test with variable association windows were calculated for obstructive apnea (OA). Odds ratios for an OA given a reflux event and for a reflux event given an OA were determined.

Results: With a Fisher exact test, a subject-specific association between MII events and OA was found in the 3 patients who required a fundoplication or had the worse clinical GER. Some level of TA was found with SI and symptom-associated probability in 6 of 7 infants. Association was found for pH >4 and pH ≤4 reflux events. pH-only events with no change of MII had only a limited role in generating CR events.

Conclusions: TA between CR events and GER was found in a single-subject–level analysis in some infants with persistent CR events at term. This TA suggests a causal relation between CR and reflux events that was further strengthened by the clinical outcomes of each infant.

Copyright 2011 by ESPGHAN and NASPGHAN


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