title: Infants under 3 months old with cyanosis at the emergency room: could it be gastroesophageal reflux?
abstract: The aim of this study is to describe the prevalence of gastroesophageal reflux disease (GERD) in infants under 3 months old with a history of cyanotic episodes, who were examined at the emergency room of a university hospital. This descriptive study reviews reports of esophageal pH monitoring from a pediatric gastroenterology service over a period of 5 years. The following data were collected: age, sex, pediatric as well as other specialists' evaluations, and the esophageal pH monitoring reports. This study included 67 infants with a history of cyanotic episodes, with no primary cause determined by pediatrician and pediatric specialists' evaluations, who underwent esophageal pH monitoring. The infants were 6-90 days old, 41 (61.2%) of them male. Fifty infants (74.6%) had at least one esophageal pH monitoring parameter above the normal limit. ZMD index was abnormal in 32 cases (48%) and reflux index was abnormal in 31 cases (46%). When other common causes of cyanosis have been ruled out, a significant proportion of infants presenting cyanosis have abnormal pH study, suggesting the role of GERD in cyanosis. The authors highlight that reflux index is not enough to conclude whether a pH study is normal or not. The ZMD index and the presence of episodes longer than 20 minutes are also important parameters for GERD diagnosis.
authors.affiliation: Department of Pediatric Gastroenterology, Hospital São Lucas (SLH), Porto Alegre, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Epifanio
authors.forename: J
authors.initials: J
authors.lastname: Eloi
authors.forename: A S
authors.initials: AS
authors.lastname: Cassiano
authors.forename: D
authors.initials: D
authors.lastname: Pinheiro
authors.forename: J V
authors.initials: JV
authors.lastname: Spolidoro
mesh_terms: D015331:Cohort Studies; D003490:Cyanosis / Q000175:diagnosis* / Q000209:etiology; D004636:Emergency Service, Hospital; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies
keywords: cyanosis; gastroesophageal reflux; infant