title: [Intraluminal impedance technique in the diagnosis of apparent life-threatening events (ALTE)].
abstract: BACKGROUND
  Apparent life threatening events (ALTE) affect children younger than one year. This syndrome is characterized by several symptoms: apnoea, change in colour or muscle tone, coughing or gagging. Approximately 50 percent of these children are diagnosed of an underlying pathology that explains the ALTEs, being gastroesophageal reflux one of the most important conditions to investigate.
  
  
  OBJECTIVE
  To demonstrate the effectiveness of intraluminal impedance technique for the diagnosis of the gastroesophageal reflux associated to ALTEs in infants.
  
  
  METHODS
  Stationary esophageal manometric is used to define the low esophageal sphincter, a pH and impedance 24 hours was recorded. We determinate association between gastroesophageal reflux-ALTEs and characterisation of the reflux that occurs.
  
  
  RESULTS
  Intraluminal esophageal impedance has been made to 16 children with the diagnosis of ALTEs between 1 and 6 months of age (mean of age 3.04 months). 23.4 episodes of reflux (9,500-31,275, P25 and P75 respectively) have been diagnosed by pHmetry whereas with impedance the number of reflux obtained were 70.88 (60.25 - 80.00), 36.21% acid and 63.78% weakly acidic. We have found 4 episodes of apnoea in one patient that seems to be connected with gastroesophageal reflux (3 nonacid and one acid event) in a statistically positive relation (SI > or = 50%; SSI > or = 10%).
  
  
  CONCLUSIONS
  Intraluminal gastroesophageal impedance is a useful method for the diagnosis of gastroesophageal reflux in infants who present a gastric alkaline content most of time, allowing in addition, to differentiate between acid and nonacid reflux. According to our sample, the patients with the diagnosis of ALTEs do not present greater rate of gastroesophageal reflux than the healthy population of the same age. Only in one patient we have found a statistically significant relation between reflux and apnoea.
authors.affiliation: Unidad de Motilidad Intestinal, Hospital Infantil Universitario Virgen del Rocío, Sevilla.
authors.forename: R Granero
authors.initials: RG
authors.lastname: Cendón
authors.forename: M J Moya
authors.initials: MJ
authors.lastname: Jiménez
authors.forename: J A Cabo
authors.initials: JA
authors.lastname: Valdés
authors.forename: I
authors.initials: I
authors.lastname: Fernández Pineda
authors.forename: I Tuduri
authors.initials: IT
authors.lastname: Limousin
authors.forename: M
authors.initials: M
authors.lastname: López-Alonso
mesh_terms: D017097:Electric Impedance; D004630:Emergencies; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008297:Male; D012120:Respiration Disorders / Q000175:diagnosis / Q000209:etiology