La impedanciometría multicanal con pHmetría de 24 h: una herramienta útil para estudiar lactantes con eventos de aparente amenaza a la vida

Abstract

Infants with events of apparent threat to life should be hospitalized for evaluation. Gastroesophageal reflux is one of the possible etiologies. Multichannel intraluminal impedanciometry – 24-hour pHmetry is a diagnostic tool that assesses the behavior of pH-independent reflux. Objectives. To describe the parameters of the gastroesophageal reflux measured by multichannel intraluminal impedanciometry – 24-hour pHmetry in infants with events of apparent threat to life. Identify if there are differences between those with positive symptomatic correlation with drowning compared to those without symptomatic correlation. Method. Descriptive, comparative, retrospective and observational study realized between 2005 and 2015. The population were infants under seven months hospitalized by events of apparent threat to life in thepediatrics sector of the Hospital Italiano who underwent multichannel intraluminal impedanciometry – 24-hour pHmetry due to suspected gastroesophageal reflux. Results. 125 patients were evaluated. The median age was 55,7 days of life (range 6-209 days). It was divided into two groups: GI: infants with symptomatic correlation with choking: (32,8% N = 41) and GII: without symptomatic correlation (67,2%, N = 84). Significant statistical differences were observed in: total number of gastroesophageal reflux episodes, episodes that reached proximal channels; clearance time, but not with number of acidic, non-acidic episodes and pHmetry score. Conclusion. Infants with episodes of events of apparent threat to life represent a diagnostic challenge. Gastroesophageal reflux is a potential trigger. The information obtained with the multichannel intraluminal impedanciometry – 24-hour pHmetry in this cohort was useful to better understand the mechanisms involved in this clinical association and thus choose the most appropriate therapy.