title: Pressure-flow characteristics of normal and disordered esophageal motor patterns.
abstract: OBJECTIVE
  To perform pressure-flow analysis (PFA) in a cohort of pediatric patients who were referred for diagnostic manometric investigation.
  
  
  METHODS
  PFA was performed using purpose designed Matlab-based software. The pressure-flow index (PFI), a composite measure of bolus pressurization relative to flow and the impedance ratio, a measure of the extent of bolus clearance failure were calculated.
  
  
  RESULTS
  Tracings of 76 pediatric patients (32 males; 9.1 ± 0.7 years) and 25 healthy adult controls (7 males; 36.1 ± 2.2 years) were analyzed. Patients mostly had normal motility (50%) or a category 4 disorder and usually weak peristalsis (31.5%) according to the Chicago Classification. PFA of healthy controls defined reference ranges for PFI ≤142 and impedance ratio ≤0.49. Pediatric patients with pressure-flow (PF) characteristics within these limits had normal motility (62%), most patients with PF characteristics outside these limits also had an abnormal Chicago Classification (61%). Patients with high PFI and disordered motor patterns all had esophagogastric junction outflow obstruction.
  
  
  CONCLUSIONS
  Disordered PF characteristics are associated with disordered esophageal motor patterns. By defining the degree of over-pressurization and/or extent of clearance failure, PFA may be a useful adjunct to esophageal pressure topography-based classification.
authors.affiliation: Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital AMC, Amsterdam, The Netherlands; Gastroenterology Unit, Women's and Children's Health Network, North Adelaide, Australia. Electronic address: m.m.j.singendonk@amc.uva.nl.
authors.forename: Maartje M J
authors.initials: MM
authors.lastname: Singendonk
authors.affiliation: Gastroenterology Unit, Women's and Children's Health Network, North Adelaide, Australia; Translational Research Center for Gastrointestinal Diseases, University of Leuven, Leuven, Belgium.
authors.forename: Stamatiki
authors.initials: S
authors.lastname: Kritas
authors.affiliation: Department of Gastroenterology and Hepatology, Repatriation General Hospital, South Australia, Australia.
authors.forename: Charles
authors.initials: C
authors.lastname: Cock
authors.affiliation: Gastroenterology Unit, Women's and Children's Health Network, North Adelaide, Australia.
authors.forename: Lara F
authors.initials: LF
authors.lastname: Ferris
authors.affiliation: Gastroenterology Unit, Women's and Children's Health Network, North Adelaide, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: McCall
authors.affiliation: Translational Research Center for Gastrointestinal Diseases, University of Leuven, Leuven, Belgium; Department of Neurosciences, ExpORL, University of Leuven, Leuven, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rommel
authors.affiliation: Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital AMC, Amsterdam, The Netherlands.
authors.forename: Michiel P
authors.initials: MP
authors.lastname: van Wijk
authors.affiliation: Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital AMC, Amsterdam, The Netherlands.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
authors.affiliation: Women's and Children's Hospital, Adelaide.
authors.forename: David
authors.initials: D
authors.lastname: Moore
authors.affiliation: Gastroenterology Unit, Women's and Children's Health Network, North Adelaide, Australia; Department of Gastroenterology and Hepatology, Repatriation General Hospital, South Australia, Australia; School of Medicine, Flinders University, Bedford Park, South Australia, Australia.
authors.forename: Taher I
authors.initials: TI
authors.lastname: Omari
mesh_terms: D000328:Adult; D002648:Child; D015154:Esophageal Motility Disorders / Q000175:diagnosis / Q000503:physiopathology*; D004947:Esophagus / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry; D010528:Peristalsis / Q000502:physiology*; D011312:Pressure; D012016:Reference Values; D012189:Retrospective Studies; D011795:Surveys and Questionnaires