A baseline impedance analysis in neurologically impaired children: A potent parameter for estimating the condition of the esophageal mucosa

• Published in: Neurogastroenterology and motility Vol. 29; no. 6
• Main Authors: Fukahori, S., Yagi, M., Ishii, S., Asagiri, K., Saikusa, N., Hashizume, N., Yoshida, M., Masui, D., Komatsuzaki, N., Higashidate, N., Nakahara, H., Tanaka, Y.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-06-2017
• Subjects: Acids; baseline impedance; Child; Child, Preschool; Children; Correlation analysis; Electric Impedance; erosive reflux disease; Esophageal Mucosa - physiopathology; Esophageal pH Monitoring - methods; Esophagitis; Esophagus; Female; Gastroesophageal reflux; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - diagnosis; Humans; Male; Mucosa; Mucous membrane; multichannel intraluminal impedance measurements; Nervous System Diseases - complications; neurologically impaired; pediatric; pH effects; Retrospective Studies; neurologically impaired; multichannel intraluminal impedance measurements; baseline impedance; erosive reflux disease; gastroesophageal reflux; pediatric
• ISSN: 1350-1925; 1365-2982
• DOI: 10.1111/nmo.13012

Background
The aim of the present study was to investigate whether the baseline impedance (BI) value is a useful parameter to evaluate the condition of the esophageal mucosa in neurologically impaired (NI) children undergoing multichannel intraluminal impedance pH measurements (pH/MII).
Methods
The retrospective study included 55 NI patients ≤15 years. The patients were divided into acid gastroesophageal reflux disease (GERD), non‐acid GERD and GERD (−) groups. Furthermore, the patients in the acid GERD group were subdivided into erosive reflux disease (ERD) and non‐erosive reflux disease (NERD) groups. pH/MII parameters and BI values (Z1‐6) were compared among three groups or between two groups, respectively. A Spearman's correlation analysis was used for the correlation analysis of pH/MII parameters and BI values. A receiver operator characteristic curve analysis was used to evaluate the optimum cut‐off values of BI to discriminate ERD patients.
Key Results
The BI values of the proximal and the distal channels in ERD group were significantly lower than those in NERD group. The BI values of the distal channels demonstrated significant negative correlations with acid exposure related pH/MII parameters. The optimal cut off value of BI in the most distal channel was determined to be 1500 Ω.
Conclusions & Inferences
The present study suggested that NI children with reflux esophagitis were likely to suffer mucosal damage up to the proximal esophagus and cut‐off BI values may help estimate the presence of reflux esophagitis. Baseline impedance is a potent parameter, reflecting the esophageal mucosal damage in NI children who have difficulty in undergoing endoscopic examinations.
The present study suggested that NI children with reflux esophagitis were likely to suffer mucosal damage up to the proximal esophagus and cut‐off BI values may help estimate the presence of reflux esophagitis. BI is a potent parameter reflecting the esophageal mucosal damage in NI children who have difficulty in undergoing endoscopic examinations.