Gastroesophageal Reflux in Severe Cases of Robin Sequence Treated with Nasopharyngeal Intubation

2009 ◽  
Vol 46 (4) ◽  
pp. 448-453 ◽  
Author(s):  
Ilza Lazarini Marques ◽  
Luiz Carlos Silveira Monteiro ◽  
Luiz de Souza ◽  
Heloísa Bettiol ◽  
Catarina Hissako Sassaki ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Prospective Study ◽  
Ph Monitoring ◽  
Oral Feeding ◽  
Respiratory Obstruction ◽  
Normal Children ◽  
Feeding Difficulties ◽  
A Value ◽  
Robin Sequence ◽  
Esophageal Ph

Objective: To study the prevalence of abnormal gastroesophageal reflux in infants with Robin sequence who had severe respiratory obstruction treated with nasopharyngeal intubation and to evaluate the efficacy of nonsurgical treatment. Design: Longitudinal prospective study. Setting: Hospital de Reabilitação de Anomalias Craniofaciais, University of São Paulo, Brazil. Patients: Twenty infants with severe isolated Robin sequence treated with nasopharyngeal intubation. Interventions: We performed 24-hour esophageal pH monitoring on each child at 2, 4, and 6 months of age. Respiratory and feeding status were evaluated. We considered abnormal gastroesophageal reflux as reflux index values above the 95th percentile of the Vandenplas reference for normal children. Results: The prevalence of reflux index above the 95th percentile at the first exam was 6/20, a value significantly higher than the reference (5/103, p < .01). At the second and third exams, reflux index values were decreased. Ninety percent of the infants showed improvement of respiratory difficulty and developed oral feeding capacity. Conclusions: The prevalence of abnormal gastroesophageal reflux is higher in infants with severe cases of Robin sequence than in normal infants. Nonsurgical procedures improved respiratory and feeding difficulties of most of these infants.

Gastroesophageal Reflux and Apnea

PEDIATRICS ◽  
1983 ◽  
Vol 72 (6) ◽  
pp. 914-914
Author(s):  
CAROL LYNN ROSEN ◽  
JAMES D. FROST ◽  
GUNYON M. HARRISON
Keyword(s):  
Gastroesophageal Reflux ◽  
Infant Formula ◽  
Ph Monitoring ◽  
Esophageal Ph Monitoring ◽  
Normal Children ◽  
Esophageal Ph ◽  
Polygraphic Recordings

In Reply.— In our study of polygraphic recordings in infants with unexplained apnea, esophageal pH was monitored continuously uously and all infants were fed standard infant formula approximately every four hours during the polygraphic studies. Orenstein has questioned the absence of gastroesophageal reflux (GER) in 36% of the pH recordings, and has suggested that nonacid feedings may have masked some episodes of GER. Other studies utilizing nonacid feedings during extended esophageal pH monitoring have shown that some normal children do not reflux and that nonacid feeds do not necessarily mask GER.

Feeding-Facilitating Techniques for the Nursing Infant with Robin Sequence

2006 ◽  
Vol 43 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Edamil Nassar ◽  
Ilza Lazarinni Marques ◽  
Alceu Sergio Trindade ◽  
Heloísa Bettiol
Keyword(s):  
Sao Paulo ◽  
Oral Feeding ◽  
São Paulo ◽  
Respiratory Obstruction ◽  
A Value ◽  
Robin Sequence ◽  
Evaluation Group ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Objective To determine the effectiveness of feeding-facilitating techniques in children with Robin sequence. Setting Hospital de Reabilitação de Anomalias Craniofaciais, University of São Paulo, Bauru, São Paulo, Brazil. Patients Twenty-six children less than 2 months of age with Robin sequence, whose only cause of respiratory obstruction was glossoptosis. Thirteen infants were treated by being placed in the prone position (Group 1), and 13 were treated by nasopharyngeal intubation (Group 2). Interventions During hospitalization, the following feeding-facilitating techniques were applied daily to all children: pacifier, massage to relax and anteriorize the tongue, long and soft bottle nipple with original or enlarged hole, global symmetric position, rhythmic movement of the nipple during suction, and insertion of the nipple on the tongue. Results During the first evaluation, Group 1 patients accepted 36.15 ± 33.05 mL milk orally within a period of 44.62 ± 42.94 minutes, whereas Group 2 ingested 20.00 ± 20.51 mL milk within 30.38 ± 25.77 minutes. A significant increase (p < .01) in the volume of ingested milk was observed for the two groups at hospital discharge after a mean treatment period of 10.7 days (Group 1: 63.46 ± 22.58 mL and Group 2: 55.00 ± 13.07 mL). The mean duration of feeding decreased in the two groups, with a value of 21.54 ± 7.18 minutes for Group 1 and of 20.28 ± 8.53 minutes for Group 2. Conclusion The results showed that feeding-facilitating techniques can foster oral feeding in infants with Robin sequence.

scholarly journals Associations of Obstructive Sleep Apnea, Obestatin, Leptin, and Ghrelin with Gastroesophageal Reflux

2021 ◽  
Vol 10 (21) ◽  
pp. 5195
Author(s):  
Piotr Pardak ◽  
Rafał Filip ◽  
Jarosław Woliński ◽  
Maciej Krzaczek
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Gastroesophageal Reflux ◽  
Ph Monitoring ◽  
Sleep Study ◽  
Esophageal Ph ◽  
Obstructive Sleep ◽  
The Relationship ◽  
Gerd Symptoms ◽  
Severe Sleep Apnea

Gastroesophageal reflux disease (GERD) is commonly observed in patients with obstructive sleep apnea (OSA). Hormonal disorders observed in OSA may be relevant in the development of GERD. The aim of the study was to assess the correlations between ghrelin, obestatin, leptin, and the intensity of GERD in patients with OSA. The study included 58 patients hospitalized due to clinical suspicion of sleep disorders during sleep. All patients underwent a sleep study, and blood samples were collected overnight for hormonal tests. Survey data concerning symptoms of GERD, gastroscopy, and esophageal pH monitoring results were included in the study. In patients with OSA, GERD was twice as common when compared to the group without OSA. Among subjects with severe sleep apnea (AHI > 30; n = 31; 53%), we observed lower ghrelin levels, especially in the second half of the night and in the morning (p5.00 = 0.0207; p7.00 = 0.0344); the presence of OSA had no effect on obestatin and leptin levels. No significant differences in hormonal levels were observed between the groups depending on the diagnosis of GERD. However, correlations of ghrelin levels with the severity of esophagitis, leptin and ghrelin levels with the severity of GERD symptoms, and leptin levels with lower esophageal pH were found. GERD is more frequent among patients with OSA. In both GERD and OSA, deviations were observed in the levels of ghrelin and leptin. However, our analysis demonstrates that the relationship between OSA and GERD does not result from these disorders.

Reliability of 24-hour home esophageal ph monitoring in diagnosis of gastroesophageal reflux

1989 ◽  
Vol 34 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Sandro Mattioli ◽  
Vladimiro Pilotti ◽  
Maurizio Spangaro ◽  
Walter F. Grigioni ◽  
Romano Zannoli ◽  
...  
Keyword(s):  
Gastroesophageal Reflux ◽  
Ph Monitoring ◽  
Esophageal Ph Monitoring ◽  
Esophageal Ph
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