Impedance-pH monitoring and conventional pH monitoring are complementary methods to detect association between gastroesophageal reflux and apnea-related symptoms in preterm infants and neonates.
OBJECTIVE
To investigate the usefulness of Multichannel intraluminal impedance-pH (MII-pH) monitoring as compared with conventional pH monitoring for detecting Gastroesophageal reflux (GER) episodes and apnea-related symptom association in preterm infants and neonates.


METHODS
Twenty-three infants (16 preterm and 7 term infants) in hospital, who underwent 24-h MII-pH monitoring, were studied retrospectively. GER indices and apnea-related symptom association were measured by both MII-pH and conventional pH based analysis.


RESULTS
Of the total 998 GER episodes assessed by MII-pH monitoring, 407 (40.8%) were acidic and 590 (59.1%) were weakly acidic. A total of 1689 GER episodes were detected by conventional pH based analysis and 270 (16%) were related to retrograde bolus movement. A total of 313 apnea-related symptoms were reported. Five patients had a positive symptom association: 3 by MII-pH, 1 by both MII-pH and conventional pH, 1 only by conventional pH.


CONCLUSIONS
Addition of MII-pH monitoring to conventional pH monitoring improves the diagnostic yield of symptom association analysis in preterm infants and neonates with apnea-related symptoms. Conventional pH monitoring is still important in the era of impedance measurement.
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
Myung Seok
MS
Shin
Jeong Ok
JO
Shim
Jin Soo
JS
Moon
Han Suk
HS
Kim
Jae Sung
JS
Ko
Jung-Hwan
JH
Choi
Jeong Kee
JK
Seo
D001049:Apnea / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D017097:Electric Impedance; D050782:Esophageal pH Monitoring; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn / Q000502:physiology; D007234:Infant, Premature / Q000502:physiology; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D009359:Neonatology / Q000379:methods; D012189:Retrospective Studies