PEDIATRICS Vol. 88 No. 4 October 1991, pp. 834-840
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Gastroesophageal Reflux, as Measured By 24-Hour pH Monitoring, in 509 Healthy Infants Screened for Risk of Sudden Infant Death Syndrome

Yvan Vandenplas MD, PhD1, Harry Goyvaerts RN2, Rudy Helven RN1, and Liliane Sacre MD1

1 From the Academisch Ziekenhuis Kinderen, Vrije Universiteit Brussel
2 Janssen Pharmaceuticals, Belgium

Continuous long-term esophageal pH monitoring has become the preferred test to quantify acid gastroesophageal reflux. Because reflux to a limited extent is physiologic, the determination of optimal thresholds to separate normal from abnormal reflux is mandatory. Esophageal pH was measured during 24 hours in 509 healthy thriving infants, aged 3 days to 1 year, using a glass microelectrode with an external reference electrode connected to a portable recorder.

Percentiles of the four parameters studied (reflux index or percent of the investigation time with a pH <4, number of episodes with a pH <4 during 24 hours, number of episodes lasting >5 minutes, the duration of the longest episode (in minutes)) are presented. A percentile curve of the reflux index regarding the age distribution shows that the normal range for the reflux index during the first 12 months of life is about 10% (95 percentile), decreasing from 13% at birth to 8% at 12 months. Application of an age-related percentile curve offers a close-to-reality possibility of data interpretation and illustrates that there is inevitably an overlap of data between normal and abnormal populations, because reflux is a phenomenon occurring to some extent in every human being.

Key Words: gastroesophageal reflux • sudden infant death syndrome • reflux index • pH monitoring

Submitted on January 17, 1990
Accepted on May 17, 1990


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