[Temporal relationship between gastroesophageal reflux and cardiorespiratory events].
The acid and non acidic gastroesophageal reflux can trigger apnoea, desaturation and bradicardia events, as well as chronic pulmonary pathology due to microaspirations, whereas the acute or chronic airway closing increase the intrathoracic pressure, triggering the reflux. Our aims were to measurement in preterms newborn the correlations between cardiorespiratory events and gastroesophageal reflux, find out the direction of this relation, identify the patients with association GER->CRE and decide the suitability of antireflux surgery.


METHODS
The study was made in the Motility Unit and in the Intensive Neonatal Care Unit, to preterms newborns without associated pathology except apnoea and/or bradicardia and/or desaturation.


METHODS
3 hours manometry study in the Motility Unit. 24 hours impedance, pH and cardiorespiratory parameters monitoring (respiratory and cardiac frequent, O2 saturation and CO2) in Intensive Neonatal Care Unit. We characterised the gastroesophageal barrier, all the reflux events and the association between GER and CRE.


RESULTS
We made 28 records to 28 patients with CRE. The average of the total number of reflux was 61 (22,25-103,00), 29,2% acid reflux and 70,8% weakly acidic. 12 patients had some GER associated with CRE but in only 2 cases was statistically significant (Sympton index: SI; Sympton Sensitivity Index: SSI) (SI > or = 50%; SSI > or = 10%). The surgical management was successfully in these two babies and nowadays they are asymptomatic.


CONCLUSIONS
There is not any general association between GER and CRE, nevertheless, in a little percentage of patients, this relationship is fulfilled and it is possible to measurement with impedance, pH and cardiorespiratory parameters. In these cases, the surgical management is the right treatment.
Moya
M J
MJ
Unidad de Motilidad Intestinal,Servicio de Cirugía Pediátrica, Hospital Infantil Virgen del Rocío, Sevilla. mariaj.moya.sspa@juntadeandalucia.es
Cabo
J A
JA
Granero
R
R
Tuduri
I
I
Fernández
I
I
Cabello
R
R
López-Alonso
M
M