Objectives: The recommended duration of Esophageal Multichannel Intraluminal Impedance pH (MII-pH) monitoring to detect gastro-esophageal reflux (GER) is currently 24 hours. This prolonged recording can be challenging in certain circumstances. We aimed to assess the diagnostic reliability of 12h versus 24h MII-pH in infants. Methods: Retrospective multicenter study assessing MII-pH tracings from infants referred for suspect GERD. Each MII-pH was analyzed twice as full-time recording and in the first 12h, and data were compared. GERD was diagnosed if one of the following occurred: Number of GER episodes ≥100 in 24 hours; proximal GER episodes >44 (acid) or 57 (non-acid); Reflux index (percent time with pH <4) >7%; Bolus Exposure Index (BEI) >2.4%; Bolus Clearance Time (BCT) >18s; Symptom index (SI) ≥50%, Symptom Association Probability (SAP) ≥95%. Univariate analysis was performed to compare MII-pH data. Results: 127 infants were studied. Median age at MII-pH was 61 days (interquartile range-IQR 27-116), 49 were born preterm. There were no significant differences between the 12h and the 24h analysis regarding the number of total GER and proximal GER events/hour, reflux index, BEI, BCT, positive SI/SAP. GER events lasting >5 minutes/hour were 1.97±0.27 and 1.83±0.44 respectively (p<0.001). The 12h MII-pH recording showed 87.7% sensitivity, 75.6% specificity, 89.7% positive predictive value, 71.7% negative predictive value for GERD compared to 24h MII-pH. Conclusions: 12h MII-pH had a good diagnostic performance compared to 24h recording. Only GER events lasting >5 minutes were significantly different between the two, but the clinical significance of this observation is unclear.
Assessing the reliability of 12 vs 24 hour esophageal pH-impedance monitoring for gastro-esophageal reflux in infants
Noviello, CarmineInvestigation
;
2025
Abstract
Objectives: The recommended duration of Esophageal Multichannel Intraluminal Impedance pH (MII-pH) monitoring to detect gastro-esophageal reflux (GER) is currently 24 hours. This prolonged recording can be challenging in certain circumstances. We aimed to assess the diagnostic reliability of 12h versus 24h MII-pH in infants. Methods: Retrospective multicenter study assessing MII-pH tracings from infants referred for suspect GERD. Each MII-pH was analyzed twice as full-time recording and in the first 12h, and data were compared. GERD was diagnosed if one of the following occurred: Number of GER episodes ≥100 in 24 hours; proximal GER episodes >44 (acid) or 57 (non-acid); Reflux index (percent time with pH <4) >7%; Bolus Exposure Index (BEI) >2.4%; Bolus Clearance Time (BCT) >18s; Symptom index (SI) ≥50%, Symptom Association Probability (SAP) ≥95%. Univariate analysis was performed to compare MII-pH data. Results: 127 infants were studied. Median age at MII-pH was 61 days (interquartile range-IQR 27-116), 49 were born preterm. There were no significant differences between the 12h and the 24h analysis regarding the number of total GER and proximal GER events/hour, reflux index, BEI, BCT, positive SI/SAP. GER events lasting >5 minutes/hour were 1.97±0.27 and 1.83±0.44 respectively (p<0.001). The 12h MII-pH recording showed 87.7% sensitivity, 75.6% specificity, 89.7% positive predictive value, 71.7% negative predictive value for GERD compared to 24h MII-pH. Conclusions: 12h MII-pH had a good diagnostic performance compared to 24h recording. Only GER events lasting >5 minutes were significantly different between the two, but the clinical significance of this observation is unclear.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
