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Expiratory Flow Increase Technique and Acid Esophageal Exposure in Infants Born Preterm With Bronchopulmonary Dysplasia

Camy, Lia Franco Serrou PT, MsC; Mezzacappa, Maria Aparecida PhD

doi: 10.1097/PEP.0b013e31823565c3
Research Articles

Objective: To determine if an expiratory flow increase technique (EFIT) is associated with acid reflux episodes in infants born preterm with bronchopulmonary dysplasia (BPD).

Methods: A crossover study was carried out. Eighteen subjects divided into 2 groups were randomly assigned to receive 2 EFIT sessions at 2 postprandial time points. Group 1 started 2 hours after feeding and group 2 started 3 hours after feeding. Esophageal acid exposure was assessed by the reflux index (RI) during EFIT and 20 minutes before EFIT by esophageal pH monitoring.

Results: A significant reduction in the RI was observed in group 1 with EFIT performed 2 hours after feeding. Group 2 showed no significant differences in RI values before and during EFIT in both postprandial periods.

Conclusion: When EFIT is performed 2 and 3 hours after feeding, it is not associated with an increase in acid reflux episodes in infants born preterm with BPD.

The EFIT, when performed 2 and 3 hours after feeding, is not associated with an increase in acid reflux episodes in preterm infants with bronchopulmonary dysplasia.

Center of Integral Attention to Women's Health—CAISM (Ms Camy) and Department of Pediatrics, School of Medical Sciences (Dr Mezzacappa), University of Campinas—UNICAMP, Campinas, São Paulo, Brazil.

Correspondence: Lia Franco Serrou Camy, PT, MsC, Rua Francisco Pereira Coutinho, 151 ap. 33B, Pq. Taquaral, 13087-120, Campinas, SP, Brazil (

Grant Support: This project was funded in part by the Foundation for Supporting Research of State of São Paulo- FAPESP Agency, under process number: 2006/54414-7.

The authors declare no conflict of interest.

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© 2011 Lippincott Williams & Wilkins, Inc.