The effects of assisted autogenic drainage, combined or not with bouncing on gastroesophageal reflux in infants.

AIM: This study aimed to determine the effect of assisted autogenic drainage (AAD) with or without bouncing (BAAD) on both acid and non-acid gastroesophageal reflux (GER) in infants <1 year. METHODS: During a 24-h multichannel intraluminal impedance-pH monitoring (MII-pH), infants were treated with a 20-min intervention of AAD (in supine position) or BAAD (in upright position), 2 h postprandial. In this controlled trial with intra-subject design, the number of reflux episodes (REs) was the primary outcome measure. The results during AAD and BAAD were compared to a baseline period before intervention and 20 min after intervention. RESULTS: Overall, 50 infants were included in both groups. During AAD a significant decrease of RE's was found compared to baseline (p = 0.001). No significant differences were found in the BAAD group compared to baseline (p = 0.125). CONCLUSION: AAD and BAAD do not cause or increase GER in infants under the age of 1 year.

Prolonged Slow Expiration Technique and Gastroesophageal Reflux in Infants Under the Age of 1 Year.

Background: The Prolonged Slow Expiration Technique (PSE) is an airway clearance technique (ACT) carried out in newborn children with bronchial obstruction and hypersecretion to clear away the mucus from the respiratory tract. Evidence about the effect of PSE on gastroesophageal reflux (GER) is currently lacking in the literature. This study aimed to evaluate the influence of PSE on GER in infants under the age of 1 year. Methods: Infants were observed using multichannel intraluminal impedance-pH monitoring (MII-pH) over 24 h. During monitoring, the participants were treated with one 20 min intervention of PSE in supine position, 2 h after feeding. In this controlled trial with intra-subject design, the number of reflux episodes (REs) during PSE were compared to 20 min before and after PSE. Results: Fifty infants younger than 1 year were screened of whom 22 had a pathological GER. For the entire group, no significant difference was seen in the total number of REs between before, during, or after the PSE treatment (P = 0.76). No significant difference in total REs was found between the three measuring points (P = 0.59) in the group of infants with an abnormal MII-pH (n = 22). Conclusion: PSE does not cause a significant difference in REs in infants younger than 1 year. Registration number: NCT03341585.

The influence of Intrapulmonary percussive ventilation on gastroesophageal reflux in infants under the age of 1 year.

BACKGROUND: Intrapulmonary percussive ventilation (IPV) is an airway clearance technique used at any age to facilitate the removal of secretions from the respiratory tract. The effect of IPV on gastroesophageal reflux(GER) is not well documented. This study aimed to determine the influence of IPV on GER in infants. METHODS: During a 24-hour multichannel intraluminal impedance-pH monitoring (MII-pH), infants in the intervention group received a20 minutes session of IPV in upright position, 2 hours postprandial. The control group received no intervention and was placed in the same position for 20 minutes, 2 hours postprandial. The number of reflux episodes (REs) during IPV as compared to the number of REs in the control group during the 20 minutes period. RESULTS: Fifty infants were included in each group;21 infants in the IPV group and 14 infants in the control group were diagnosed with abnormal MII-pH (P = .142). During IPV, the number of REs was significantly lower than in the control group (P < .001). Also in the subgroups with abnormal or normal MII-pH, a significantly lower number of REs during IPV was found (P = .011, P = .011 respectively). CONCLUSION: IPV decreases the number of REs in infants independent of the results of MII-pH.