Pressure-flow characteristics of normal and disordered esophageal motor patterns

Maartje M J Singendonk, Stamatiki Kritas, Charles Cock, Lara F Ferris, Lisa McCall, Nathalie Rommel, Michiel P van Wijk, Marc A Benninga, David Moore, Taher I Omari

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVE: To perform pressure-flow analysis (PFA) in a cohort of pediatric patients who were referred for diagnostic manometric investigation.

STUDY DESIGN: PFA was performed using purpose designed Matlab-based software. The pressure-flow index (PFI), a composite measure of bolus pressurization relative to flow and the impedance ratio, a measure of the extent of bolus clearance failure were calculated.

RESULTS: Tracings of 76 pediatric patients (32 males; 9.1 ± 0.7 years) and 25 healthy adult controls (7 males; 36.1 ± 2.2 years) were analyzed. Patients mostly had normal motility (50%) or a category 4 disorder and usually weak peristalsis (31.5%) according to the Chicago Classification. PFA of healthy controls defined reference ranges for PFI ≤142 and impedance ratio ≤0.49. Pediatric patients with pressure-flow (PF) characteristics within these limits had normal motility (62%), most patients with PF characteristics outside these limits also had an abnormal Chicago Classification (61%). Patients with high PFI and disordered motor patterns all had esophagogastric junction outflow obstruction.

CONCLUSIONS: Disordered PF characteristics are associated with disordered esophageal motor patterns. By defining the degree of over-pressurization and/or extent of clearance failure, PFA may be a useful adjunct to esophageal pressure topography-based classification.

Original languageEnglish
Pages (from-to)690-6.e1
JournalJournal of Pediatrics
Volume166
Issue number3
DOIs
Publication statusPublished - Mar 2015

Cite this

Singendonk, M. M. J., Kritas, S., Cock, C., Ferris, L. F., McCall, L., Rommel, N., ... Omari, T. I. (2015). Pressure-flow characteristics of normal and disordered esophageal motor patterns. Journal of Pediatrics, 166(3), 690-6.e1. https://doi.org/10.1016/j.jpeds.2014.12.002