title: Cardiac, respiratory, and arousal responses to an esophageal acid infusion test in near-term infants during active sleep.
abstract: This study was designed to determine the cardiac, respiratory, and arousal responses to an esophageal acid infusion test in near-term infants free from neurological, gastroesophageal, and cardiopulmonary disease at time of testing during active sleep. Eight infants (gestational age 28-37.5 weeks, postconceptional age 36-40 weeks) were tested. Using standardized procedures and timing, we compared the cardiac, respiratory and arousal responses during a control period and during distal esophageal saline and acid infusion periods. The duration of each of these periods was 5 min. The pH of the acid infusion was 2.2. We found that this mild distal esophageal acid infusion test induced significant prolongation of the interval between successive electrocardiogram R waves compared with control and saline infusion periods (806.5 +/- 145.7 ms, 478.8 +/- 49.4 ms, and 468.8 +/- 37.2 ms, respectively; p less than 0.01) and of the duration of the respiratory cycle (2.9 +/- 0.7 s, 1.5 +/- 0.3 s, and 1.5 +/- 0.2 s, respectively; p less than 0.01). Esophageal acid infusion elicited significant electroencephalogram (EEG) arousal responses. The number of the EEG arousals was significantly increased during the acid period as compared with control and saline infusion periods (2.9 +/- 1.4, 0.5 +/- 0.5, and 0.4 +/- 0.5, respectively; p less than 0.01). Total arousal duration was significantly increased during acid as compared with control and saline infusion periods (42 +/- 17.5 s, 4.5 +/- 5.1 s, and 3.5 +/- 5.0 s, respectively; p less than 0.01). We conclude that distal esophageal acid stimulation elicits significant cardiac, respiratory, and EEG arousal responses in near-term infants during active sleep.
authors.affiliation: Laboratory of Physiology, INSERM CJF 8909, Clamart, France.
authors.forename: J
authors.initials: J
authors.lastname: Ramet
authors.forename: L
authors.initials: L
authors.lastname: Egreteau
authors.forename: L
authors.initials: L
authors.lastname: Curzi-Dascalova
authors.forename: P
authors.initials: P
authors.lastname: Escourrou
authors.forename: M
authors.initials: M
authors.lastname: Dehan
authors.forename: C
authors.initials: C
authors.lastname: Gaultier
mesh_terms: D000284:Administration, Oral; D001143:Arousal / Q000187:drug effects / Q000502:physiology*; D004562:Electrocardiography / Q000187:drug effects; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D005744:Gastric Acid / Q000502:physiology; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006321:Heart / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011189:Potassium Chloride / Q000008:administration & dosage*; D012119:Respiration / Q000187:drug effects / Q000502:physiology*; D012890:Sleep / Q000187:drug effects / Q000502:physiology*; D013464:Sulfuric Acids / Q000008:administration & dosage*
chemical_list: D013464:Sulfuric Acids; D011189:Potassium Chloride; C033158:sulfuric acid