High‐resolution esophageal manometry in pediatrics: Effect of esophageal length on diagnostic measures

Autor: Grace Seiboth, Taher Omari, Charles Cock, Rammy Abu-Assi, Lisa McCall, Marc A. Benninga, Maartje Singendonk, David J. Moore, Katie Lowe, Lara Ferris, Richard Couper, Michiel P. van Wijk, Paul Hammond
Přispěvatelé: Graduate School, Paediatric Gastroenterology, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, ARD - Amsterdam Reproduction and Development, Pediatric surgery
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Neurogastroenterology and Motility
Singendonk, M M J, Ferris, L F, McCall, L, Seiboth, G, Lowe, K, Moore, D, Hammond, P, Couper, R, Abu-Assi, R, Cock, C, Benninga, M A, van Wijk, M P, Omari, T I & In Association with the European Society for Pediatric Gastroenterology, Hepatology, Nutrition (ESPGHAN) Pediatric Motility Network 2020, ' High-resolution esophageal manometry in pediatrics : Effect of esophageal length on diagnostic measures ', Neurogastroenterology and Motility, vol. 32, no. 1, e13721 . https://doi.org/10.1111/nmo.13721
Neurogastroenterology and motility, 32(1):e13721. Wiley-Blackwell
Neurogastroenterology and Motility, 32(1):e13721. Wiley-Blackwell Publishing Ltd
ISSN: 1365-2982
1350-1925
Popis: Background High‐resolution esophageal manometry (HREM), derived esophageal pressure topography metrics (EPT), integrated relaxation pressure (IRP), and distal latency (DL) are influenced by age and size. Combined pressure and intraluminal impedance also allow derivation of metrics that define distension pressure and bolus flow timing. We prospectively investigated the effects of esophageal length on these metrics to determine whether adjustment strategies are required for children. Methods Fifty‐five children (12.3 ± 4.5 years) referred for HREM, and 30 healthy adult volunteers (46.9 ± 3.8 years) were included. Studies were performed using the MMS system and a standardized protocol including 10 × 5 mL thin liquid bolus swallows (SBM kit, Trisco Foods) and analyzed via Swallow Gateway (http://www.swallowgateway.com). Esophageal distension pressures and swallow latencies were determined in addition to EGJ resting pressure and standard EPT metrics. Effects of esophageal length were examined using partial correlation, correcting for age. Adult‐derived upper limits were adjusted for length using the slopes of the identified linear equations. Key Results Mean esophageal length in children was 16.8 ± 2.8 cm and correlated significantly with age (r = 0.787, P = .000). Shorter length correlated with higher EGJ resting pressure and 4‐s integrated relaxation pressures (IRP), distension pressures, and shorter contraction latencies. Ten patients had an IRP above the adult upper limit. Adjustment for esophageal length reduced the number of patients with elevated IRP to three. Conclusions & Inferences We prospectively confirmed that certain EPT metrics, as well as potential useful adjunct pressure‐impedance measures such as distension pressure, are substantially influenced by esophageal length and require adjusted diagnostic thresholds specifically for children.
Esophageal length has a significant impact on key esophageal pressure topography metrics and other novel metrics, such as bolus distension pressure (DP), which may be a useful adjunct measure of outflow obstruction. These effects must be considered in the pediatric setting.
Databáze: OpenAIRE
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