Document Detail

Airway obstruction and gastroesophageal reflux: an experimental study on the pathogenesis of this association.
MedLine Citation:
PMID:  8229606     Owner:  NLM     Status:  MEDLINE    
Gastroesophageal reflux (GER) frequently complicates the clinical course of children suffering from conditions leading to upper airway obstruction (UAO) (choanal atresia, tracheomalacia, esophageal atresia, vascular rings, etc). In an attempt to explore whether partial airway obstruction causes changes in the normal thoracoabdominal pressure gradients, we measured end-inspiratory intrathoracic and intraabdominal pressures in anesthetized rats under spontaneous breathing conditions, after tracheostomy, and under upper airway obstruction induced by tracheal intubation with three progressively narrower cannulae (inner diameters 1.0 mm, 0.5 mm, and 0.2 mm). We also measured the lower esophageal sphincter pressure (LESP) and length (LESL) and calculated the thoracoabdominal end-inspiratory pressure gradient (TAEIPG). Neither LESP nor LESL changed significantly before or after maximal tracheal obstruction (14.3 +/- 6.2 v 18 +/- 7.6 cm H2O [P > .05] and 0.34 +/- 0.09 v 0.41 +/- 0.1 cm H2O [P > .05] respectively) but TAEIPG significantly increased from 5.58 +/- 1.34 cm H2O to 17.62 +/- 4.27 cm H2O (P < .01) under the same conditions, mainly as a result of progressively increasing negative intrathoracic pressures during inspiration. These experiments prove that the powerful thoracoabdominal pressure gradients developed after partial UAO may contribute to the pathogenesis of GER by overcoming the antireflux barrier function. This study points out the convenience of routinely screening for GER all children with airway obstructive conditions, bearing in mind that the reestablishment of normal respiratory conditions should be the primary goal of treatment.
W Wang; J A Tovar; I Eizaguirre; P Aldazabal
Related Documents :
785646 - Continuous positive airway pressure in the prophylaxis of the adult respiratory distres...
16264036 - Use of continuous positive airway pressure during flexible bronchoscopy in young children.
19846406 - Randomized crossover comparison between the i-gel and the lma-unique in anaesthetized, ...
15298876 - Comparison of the lma-proseal and lma-classic in children.
18413386 - Diastolic filling parameters derived from myocardial perfusion imaging can predict left...
11094816 - Continuous estimation of systolic blood pressure using the pulse arrival time and inter...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  28     ISSN:  0022-3468     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  1993 Aug 
Date Detail:
Created Date:  1993-12-10     Completed Date:  1993-12-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  995-8     Citation Subset:  IM    
Universidad del País Vasco, Hospital N.S. de Aranzazu, San Sebastián, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Airway Obstruction / physiopathology*
Esophagogastric Junction / physiopathology
Gastroesophageal Reflux / physiopathology*
Hydrostatic Pressure
Rats, Wistar
Work of Breathing / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Development of a technique for jejunal interposition in long-gap esophageal atresia.
Next Document:  An association of pulmonary hypoplasia with unilateral agenesis of the diaphragm.