미숙아에서 위식도 역류와 무호흡간의 관계
1999
Background/Aims: In the preterm infants, gastroesophageal reflux (GER) has been associated with apnea. The aim of this study was to determine the effects of feeding, chest physiotherapy, and me
chanical ventilation on GER, and to evaluate the association between GER and apnea in preterm
infants. Methods: The 24 hour esophageal pH was recorded using a monocrystalline antimony
electrode for 22 preterm infants. The mean gestational age and postconceptional age were 31 and 34
weeks, respectively. The mean birth weight was 1,835 g. Patients were classified into three groups
eight infants without apnea; seven infants with xanthine sensitive apnea; seven infants with xanthine
resistant apnea who had frequent attacks of apnea that were unaffected by the adminstration of ami
nophylline. Results: The mean reflux index was 7.2% and the longest episode was 17.8 minutes
Physiotherapy was associated with a significant increase in the amount of reflux. The GER index
during mechanical ventilation (1.0%) was significantly less than that during normal breathing (9.0%)
The mean reflux index in no apnea group, xanthine sensitive apnea group, and xanthine resistan
apnea group was 3.9%, 5.6%, and 12.6%, respectively. Conclusions: GER should be considered as
a cause of xanthine resistant apnea in preterm infants. (Kor J Gastroenterol 1998;32:733 - 739)
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