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Normal values and regional differences in oesophageal impedance-pH metrics: a consensus analysis of impedance-pH studies from around the world
- Source :
- Sifrim, D, Roman, S, Savarino, E, Bor, S, Bredenoord, A J, Castell, D, Cicala, M, de Bortoli, N, Frazzoni, M, Gonlachanvit, S, Iwakiri, K, Kawamura, O, Krarup, A, Lee, Y Y, Soon Ngiu, C, Ndebia, E, Patcharatraku, T, Pauwels, A, Pérez de la Serna, J, Ramos, R, Remes-Troche, J M, Ribolsi, M, Sammon, A, Simren, M, Tack, J, Tutuian, R, Valdovinos, M, Xiao, Y, Zerbib, F & Gyawali, C P 2021, ' Normal values and regional differences in oesophageal impedance-pH metrics : a consensus analysis of impedance-pH studies from around the world ', Gut, vol. 70, no. 8, pp. 1441–1449 . https://doi.org/10.1136/gutjnl-2020-322627, Gut, 70(8), 1441-1449. BMJ Publishing Group
- Publication Year :
- 2021
-
Abstract
- Objective Limitations of existing impedance-pH thresholds include small sample size of normative studies, inclusion of artefactual pH drops and incorrect identification of impedance reflux events. We aimed to obtain new impedance-pH thresholds from expert consensus analysis of tracings from a large number of healthy subjects. Design Of 541 studies performed worldwide using two different systems (Diversatek, USA, and Laborie, Netherlands), 150 tracings with oesophageal diagnoses, behavioural disorders and study-related artefacts were excluded. The remainder studies were subject to two reviewer consensus analysis, in-person or through video conference, consisting of editing meals and pH drops, identification of impedance reflux and postreflux swallow-induced peristaltic wave (PSPW) using strict pre-established criteria and measurement of distal mean nocturnal baseline impedance (MNBI). Results Consensus analysis was performed in 391 tracings (age 32.7 years, range 18-71, 54.2% female). Normative thresholds were significantly different between Diversatek and Laborie (total acid exposure time: 2.8% and 5%; reflux episodes: 55 and 78; MNBI at 3 cm: 1400 and 1500 ohms, at 5 cm: 1400 and 1800 ohms). Males had higher acid exposure, more reflux episodes and lower MNBI. Significant regional differences were identified, including higher PSPW scores in Western countries, and higher MNBI in Asia using Diversatek, and higher acid exposure in the Netherlands, higher MNBI in Asia and South Africa, and lower MNBI in Turkey using Laborie. Conclusion Normal impedance-pH monitoring thresholds have regional and system-related differences. Clinical interpretation needs to use normal thresholds valid for the system used and world region, following careful editing of the tracings.<br />Queen Mary University of London, UK [DDCH1A3R]<br />The study was conducted with financial support from Research Grant DDCH1A3R, Queen Mary University of London, UK.
- Subjects :
- Impedance–pH monitoring
medicine.medical_specialty
Normal values
Behavioural disorders
Audiology
Agreement
Intraobserver
03 medical and health sciences
0302 clinical medicine
post reflux swallow-induced peristaltic wave
Medicine
Disease
Baseline impedance
acid exposure time
impedance-pH monitoring
reflux episodes
Variability
Children
Interobserver
business.industry
Gastroenterology
Healthy subjects
Small sample
Multichannel Intraluminal Impedance
Reproducibility
Consensus analysis
030220 oncology & carcinogenesis
Gastroesophageal-Reflux
030211 gastroenterology & hepatology
Base-Line Impedance
business
Regional differences
Subjects
Details
- Language :
- English
- ISSN :
- 00175749
- Database :
- OpenAIRE
- Journal :
- Sifrim, D, Roman, S, Savarino, E, Bor, S, Bredenoord, A J, Castell, D, Cicala, M, de Bortoli, N, Frazzoni, M, Gonlachanvit, S, Iwakiri, K, Kawamura, O, Krarup, A, Lee, Y Y, Soon Ngiu, C, Ndebia, E, Patcharatraku, T, Pauwels, A, Pérez de la Serna, J, Ramos, R, Remes-Troche, J M, Ribolsi, M, Sammon, A, Simren, M, Tack, J, Tutuian, R, Valdovinos, M, Xiao, Y, Zerbib, F & Gyawali, C P 2021, ' Normal values and regional differences in oesophageal impedance-pH metrics : a consensus analysis of impedance-pH studies from around the world ', Gut, vol. 70, no. 8, pp. 1441–1449 . https://doi.org/10.1136/gutjnl-2020-322627, Gut, 70(8), 1441-1449. BMJ Publishing Group
- Accession number :
- edsair.doi.dedup.....c50580ec28af634807e863ac0a891a33