Maissa Rayyan1,2, Taher Omari3, Anne Debeer1,2, Karel Allegaert2,4,5, Nathalie Rommel6,7,8. 1. Neonatal Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium. 2. Department of Development and Regeneration, KU Leuven, Leuven, Belgium. 3. College of Medicine & Public health, Flinders University, Adelaide, Australia. 4. Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium. 5. Department of Clinical Pharmacy, Erasmus Medical Center, Rotterdam, The Netherlands. 6. Department of Neurosciences, Experimental ORL, KU Leuven, Leuven, Belgium. 7. Neurogastroenterology and Motility, Gastroenterology, University Hospitals Leuven, Leuven, Belgium. 8. Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium.
Abstract
BACKGROUND: To characterize esophageal motility and function of the esophagogastric junction (EGJ) in preterm infants with bronchopulmonary dysplasia (BPD). METHODS: High-resolution manometry with impedance was used to investigate esophageal motility and EGJ function in 28 tube-fed preterm infants with BPD. Patients with BPD were studied at term age during oral feeding. Thirteen healthy term-aged infants were included as controls. Esophageal analysis derived objective measures to evaluate esophageal contractile vigor, bolus distension pressure, EGJ relaxation, and EGJ barrier function (in rest and during respiration). In addition, we investigated the effect of BPD severity on these measures. KEY RESULTS: A total of 140 nutritive swallows were analyzed (BPD, n = 92; controls, n = 48). Normal esophageal peristaltic wave patterns were observed in all infants. BPD patients had higher distal contractile esophageal strength compared with controls (Kruskal-Wallis (KW) P = .048), and their deglutitive EGJ relaxation was comparable to controls. Severe BPD patients showed higher bolus distension pressures, higher EGJ resting pressures, and increased EGJ contractile integrals compared with mild BPD patients (Mann-Whitney U P = .009, KW P = .012 and KW P = .028, respectively). CONCLUSIONS AND INFERENCES: Preterm infants with BPD consistently present with normal peristaltic esophageal patterns following nutritive liquid swallows. The EGJ barrier tone and relaxation pressure appeared normal. In general, infants with BPD do not have altered esophageal motor function. There is however evidence for increased flow resistance at the EGJ in severe BPD patients possibly related to an increased contractility of the diaphragm.
BACKGROUND: To characterize esophageal motility and function of the esophagogastric junction (EGJ) in preterm infants with bronchopulmonary dysplasia (BPD). METHODS: High-resolution manometry with impedance was used to investigate esophageal motility and EGJ function in 28 tube-fed preterm infants with BPD. Patients with BPD were studied at term age during oral feeding. Thirteen healthy term-aged infants were included as controls. Esophageal analysis derived objective measures to evaluate esophageal contractile vigor, bolus distension pressure, EGJ relaxation, and EGJ barrier function (in rest and during respiration). In addition, we investigated the effect of BPD severity on these measures. KEY RESULTS: A total of 140 nutritive swallows were analyzed (BPD, n = 92; controls, n = 48). Normal esophageal peristaltic wave patterns were observed in all infants. BPDpatients had higher distal contractile esophageal strength compared with controls (Kruskal-Wallis (KW) P = .048), and their deglutitive EGJ relaxation was comparable to controls. Severe BPDpatients showed higher bolus distension pressures, higher EGJ resting pressures, and increased EGJ contractile integrals compared with mild BPDpatients (Mann-Whitney U P = .009, KW P = .012 and KW P = .028, respectively). CONCLUSIONS AND INFERENCES: Preterm infants with BPD consistently present with normal peristaltic esophageal patterns following nutritive liquid swallows. The EGJ barrier tone and relaxation pressure appeared normal. In general, infants with BPD do not have altered esophageal motor function. There is however evidence for increased flow resistance at the EGJ in severe BPDpatients possibly related to an increased contractility of the diaphragm.
Authors: Corine Bürgin; Patrizia Simmen; Nishant Gupta; Lilian Suter; Samuel Kreuzer; Andreas Haeberlin; Sven M Schulzke; Daniel Trachsel; Thomas Niederhauser; Kerstin Jost Journal: Pediatr Res Date: 2021-10-02 Impact factor: 3.756