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Diagnosing gastroesophageal reflux in preterm Infants.

Publication: Pediatrics
Publication Date: 01-AUG-06 		Format: Online
Delivery: Immediate Online Access

Article Excerpt
PRETERM INFANTS ARE exposed to a host of therapeutic agents, and drug therapy for presumed gastroesophageal reflux (GER) ranks high on any list. It was documented recently that 25% of all extremely low birth weight (<1 kg) infants are discharged on promotility and/or antacid therapy, (1) The most common indications for these drugs comprise feeding intolerance and recurrent episodes of apnea/bradycardia/desaturation, (2) Unfortunately, there is little evidence to support this widely practiced approach. The article by Lopez-Alonso et al (3) (in this month's issue of Pediatrics Electronic Pages) provides revealing new data to help us characterize GER in preterm infants.

Traditionally, GER has been quantified by measurement of esophageal pH. However, because frequent feeds in infants neutralize stomach contents, this measure is potentially unreliable. Intraluminal impedance, as used by Lopez-Alonso et al, is pH-independent and measures reflux from retrograde flow of a liquid (or air) bolus...

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