SIMULTANEOUS TRACHEAL AND ESOPHAGEAL PH MEASUREMENTS IN ASTHMATIC-PATIENTS WITH GASTROESOPHAGEAL REFLUX

被引:154
作者
JACK, CIA
CALVERLEY, PMA
DONNELLY, RJ
TRAN, J
RUSSELL, G
HIND, CRK
EVANS, CC
机构
[1] CARDIOTHORAC CTR,LIVERPOOL L14 3PE,MERSEYSIDE,ENGLAND
[2] UNIV LIVERPOOL,DEPT MED,LIVERPOOL L69 3BX,MERSEYSIDE,ENGLAND
关键词
GASTROESOPHAGEAL REFLUX; ASTHMA; PH MEASUREMENTS;
D O I
10.1136/thx.50.2.201
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background - An association between asthma and gastro-oesophageal reflux is well recognised but the underlying mechanism is unclear. One suggestion is that gastric juice is aspirated into the tracheal and upper airways but detection of these events is difficult and involves radioisotopic studies. A new method of making direct measurements of tracheal and oesophageal pH over a 24 hour period is described, together with its application to patients with asthma. Methods - The technique involves insertion of simultaneous tracheal and oesophageal pH probes under general anaesthesia. Continuous monitoring of pH over a 24 hour period is possible, permitting comparison with peak flow readings during wakefulness and at night should the patient be disturbed. Representative data from four patients with asthma (mean FEV(1) 62% predicted) and symptomatic gastro-oesophageal reflux, together with data from three non-asthmatics, is presented. Results - Thirty seven episodes of gastrooesophageal reflux lasting more than five minutes were recorded. Of these, five were closely followed by a fall in tracheal pH from a mean (SE) of 7.1 (0.2) to 4.1 (0.4) and a fall in peak expiratory flow (PEFR) of 84 (16) 1/min. When gastrooesophageal reflux occurred without tracheal aspiration the fall in PEFR was 8 (4) 1/min. Conclusions - This new technique was well tolerated and allowed quantitation of the number, duration, and timing of episodes of tracheal micro-aspiration. Unlike acid reflux without aspiration, these events appear to be related to significant acute changes in lung function in asthmatic patients. Further studies with this new method may elucidate the role of gastrooesophageal reflux in asthma.
引用
收藏
页码:201 / 204
页数:4
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