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Post-publication Peer Reviews to:

ARTICLES:
Rachel Rosen, Julia Fritz, Ariela Nurko, Dawn Simon, and Samuel Nurko
Lipid-Laden Macrophage Index Is Not an Indicator of Gastroesophageal Reflux-Related Respiratory Disease in Children
Pediatrics 2008; 121: e879-e884 [Abstract] [Full text] [PDF]
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[Read P3R] Fallacy of Positive GER Testing
Wallace F Berman   (9 April 2008)

Fallacy of Positive GER Testing 9 April 2008
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Wallace F Berman,
MD
Duke University Medical Center

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Re: Fallacy of Positive GER Testing

wallace.berman{at}duke.edu Wallace F Berman

Unfortunately, the number of reflux episodes documented either acid or non-acid does not predict episodes of aspiration. In patients where aspiration is occuring, only a single episode of reflux is sufficient to allow aspiration of gastric contents. Often confusing is the interpretation of reflux study as normal rather than none. It is a bit premature to suggest that monitoring of esophageal contents is adequate to rule out aspiration. This is not to suggest that the finding of lipid laden macrophages in pulmonary aspirates is diagnostic of aspiration, but a "normal" GER study does not rule it out.

Conflict of Interest:

None declared