Comparación entre pH-metría convencional e impedanciometría intraluminal multicanal en niños con patología respiratoria
- María del Mar Tolín Hernani
- Marta Crespo Medina
- Vanessa Luengo Herrero
- Carmen Martínez López
- Antonio Salcedo Posadas
- Guillermo Álvarez Calatayud
- José Luis Morales Pérez
- César Sánchez Sánchez
ISSN: 1695-4033, 1696-4608
Año de publicación: 2012
Volumen: 77
Número: 2
Páginas: 103-110
Tipo: Artículo
Otras publicaciones en: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Resumen
Introduction Gastroesophageal reflux (GER) is associated with respiratory symptoms. The link between non-acid GER and the pathogenesis of respiratory disease has been demonstrated. Esophageal multichannel intraluminal impedance (MII) is able to detect non-acid and alkaline GER, as well as reflux height. The objective of the study was to compare the diagnostic effectiveness of dual-channel pH-meter and MII. Patients and methods A prospective study was conducted on patients diagnosed with uncontrolled asthma, persistent cough, or chronic laryngitis. Patients were monitored continuously for 24hours using a combination of MII and a dual-channel pH-meter. A descriptive and comparative analysis of the techniques was performed using the t test for comparison between groups and McNemar test for non-parametric data. Results A total of 49 patients with respiratory disease between September 2008 and April 2010 (79.6% uncontrolled asthma, 10.2% persistent cough, and 10.2% chronic laryngitis) were included in the study. The mean number of refluxes detected was 18.3 (range 0-93) using the pH-meter and 39.2 (11-119) using MII (P<.001). Acid GER was detected using pH in 7 children and using MII in 25 children (8 acid, 10 alkaline and 7 mixed). A mean of 21 proximal refluxes were detected using MII. Conclusions MII makes it possible to diagnose a greater number of refluxes, whether acid or alkaline, than conventional pH measurement in children with respiratory disease that is poorly controlled with their usual treatment. MII can also detect proximal refluxes