Faculty Collaboration Database

Esophageal body and upper esophageal sphincter motor responses to esophageal provocation during maturation in preterm newborns. J Pediatr 2003 Jul;143(1):31-8

Date

08/14/2003

Pubmed ID

12915821

DOI

10.1016/S0022-3476(03)00242-7

Scopus ID

2-s2.0-0042744805 (requires institutional sign-in at Scopus site)   96 Citations

Abstract

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.

Author List

Jadcherla SR, Duong HQ, Hoffmann RG, Shaker R

Author

Reza Shaker MD Assoc Provost, Sr Assoc Dean, Ctr Dir, Chief, Prof in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Deglutition Disorders
Differential Threshold
Electromyography
Esophageal Motility Disorders
Esophagus
Female
Gastroesophageal Reflux
Gestational Age
Humans
Infant, Newborn
Infant, Premature
Male
Manometry
Muscle, Smooth
Severity of Illness Index