Document Detail


Esophageal body and upper esophageal sphincter motor responses to esophageal provocation during maturation in preterm newborns.
MedLine Citation:
PMID:  12915821     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We studied the maturation of esophageal body and upper esophageal sphincter (UES) motor responses that protect against reflux in newborns. STUDY DESIGN: The responses of esophageal body and UES on midesophageal provocation were quantified using a micromanometric water perfusion system and a specially designed catheter with a UES sleeve and 5 side-hole recording sites. Eighteen healthy premature infants were studied twice, at 33.4 weeks' and 35.7 weeks' mean postmenstrual ages (PMAs). RESULTS: Mean threshold volumes and the distribution of responses including secondary peristalsis, UES pressure increase, and primary peristalsis were similar for air and liquids. Secondary peristalsis and UES pressure increases were volume dependent for both studies, but their characteristics changed as PMA increased in that (1) completely propagated secondary peristalsis with liquids increased; (2) proximal esophageal contraction duration was shorter for air and liquids; and (3) propagating velocity for liquids was faster. CONCLUSIONS: Esophageal and UES motor responses to abrupt midesophageal provocation are present as early as 33 weeks' PMA, and the response-characteristics improve during development. Reflexes that may facilitate esophageal clearance include (1) secondary peristalsis; (2) esophago-UES-contractile reflex; and (3) esophago-deglutition response.
Authors:
Sudarshan Rao Jadcherla; Hao Q Duong; Raymond G Hoffmann; Reza Shaker
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  143     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-08-13     Completed Date:  2003-09-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  31-8     Citation Subset:  AIM; IM    
Affiliation:
Section of Neonatology, Columbus Children's Hospital and Children's Research Institute, Department of Pediatrics, The Ohio State University College of Medicine and Public Health, 43205, USA. jadcherlas@pediatrics.ohio-state.edu
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MeSH Terms
Descriptor/Qualifier:
Deglutition Disorders / etiology
Differential Threshold / physiology
Electromyography / instrumentation
Esophageal Motility Disorders / complications,  diagnosis*,  physiopathology*
Esophagus / physiopathology*
Female
Gastroesophageal Reflux / diagnosis,  etiology,  physiopathology
Gestational Age
Humans
Infant, Newborn
Infant, Premature
Male
Manometry / instrumentation
Muscle, Smooth / physiopathology
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
1 R03 DK61502/DK/NIDDK NIH HHS; M01-RR00058/RR/NCRR NIH HHS

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