Faculty Collaboration Database

Effect of maturation of the magnitude of mechanosensitive and chemosensitive reflexes in the premature human esophagus. J Pediatr 2006 Jul;149(1):77-82

Date

07/25/2006

Pubmed ID

16860132

Pubmed Central ID

PMC4075758

DOI

10.1016/j.jpeds.2006.02.041

Scopus ID

2-s2.0-33746128003 (requires institutional sign-in at Scopus site)   77 Citations

Abstract

OBJECTIVES: To investigate the effect of esophageal mechanosensitive and chemosensitive stimulation on the magnitude and recruitment of peristaltic reflexes and upper esophageal sphincter (UES)-contractile reflex in premature infants.

STUDY DESIGN: Esophageal manometry and provocation testing were performed in the same 18 neonates at 33 and 36 weeks postmenstrual age (PMA). Mechanoreceptor and chemoreceptor stimulation were performed using graded volumes of air, water, and apple juice (pH 3.7), respectively. The frequency and magnitude of the resulting esophago-deglutition response (EDR) or secondary peristalsis (SP), and esophago-UES-contractile reflex (EUCR) were quantified.

RESULTS: Threshold volumes to evoke EDR, SP, or EUCR were similar. The recruitment and magnitude of SP and EUCR increased with volume increments of air and water in either study (P < .05). However, apple juice infusions resulted in increased recruitment of EDR in the 33 weeks group (P < .05), and SP in the 36 weeks group (P < .05). The magnitude of EUCR was also volume responsive (all media, P < .05), and significant differences between media were noted (P < .05). At maximal stimulation (1 mL, all media), sensory-motor characteristics of peristaltic and EUCR reflexes were different (P < .05) between media and groups.

CONCLUSIONS: Mechano- and chemosensitive stimuli evoke volume-dependent specific peristaltic and UES reflexes at 33 and 36 weeks PMA. The recruitment and magnitude of these reflexes are dependent on the physicochemical properties of the stimuli in healthy premature infants.

Author List

Jadcherla SR, 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

Air
Beverages
Chemoreceptor Cells
Deglutition
Esophagus
Evoked Potentials, Motor
Female
Humans
Infant
Infant, Newborn
Infant, Premature
Male
Manometry
Mechanoreceptors
Muscle Contraction
Perfusion
Peristalsis
Recruitment, Neurophysiological
Reflex
Sensory Thresholds
Water