PMID- 22241570
OWN - NLM
STAT- MEDLINE
DCOM- 20120522
LR  - 20221129
IS  - 1099-0496 (Electronic)
IS  - 1099-0496 (Linking)
VI  - 47
IP  - 2
DP  - 2012 Feb
TI  - Acid and non-acid reflux during physiotherapy in young children with cystic 
      fibrosis.
PG  - 119-24
LID - 10.1002/ppul.21524 [doi]
AB  - BACKGROUND: Gastro-esophageal reflux (GOR) may contribute to lung disease in 
      children with cystic fibrosis (CF). There is conflicting evidence regarding the 
      effect of chest physiotherapy (CPT) in the head-down position on GOR. 
      Furthermore, there is currently no evidence on the impact of physiotherapy on GOR 
      as assessed by pH-multichannel intraluminal impedance (pH-MII). AIMS: (1) To 
      characterize GOR in young children with CF. (2) To determine whether the 
      head-down position during physiotherapy exacerbates GOR. METHODS: Children were 
      studied using pH-MII monitoring over 24-hr, during which they received two 20-min 
      sessions of CPT. One session was performed in "modified" drainage positions with 
      no head-down tilt and the alternate session in "gravity-assisted" drainage 
      positions, which included 20 degrees  head-down tilt. RESULTS: Twenty children with CF (8 
      males), median age 12 months (range 8-34) were recruited. A total of 1,374 reflux 
      episodes were detected in all children, of which 869 (63%) were acid and 505 
      (37%) were non-acid. Seventy-two percent of the episodes migrated proximally. 
      During CPT, there was no significant difference between total number of reflux 
      episodes in the modified or gravity-assisted positions, median [inter-quartile 
      range (IQR)] 1 (0-2.5) compared to 1 (0.75-3) episode, respectively, P = 0.63. 
      There was also no significant difference between the number of reflux episodes 
      which migrated proximally, median (IQR) 1 (0-2) compared to 0 (0-2) episodes, 
      respectively, P = 0.75. CONCLUSION: In young children with CF, GOR is primarily 
      acidic and proximal migration is common. Physiotherapy in the head-down position 
      does not appear to exacerbate GOR. The impact of GOR on lung disease remains to 
      be elucidated.
CI  - Copyright (c) 2011 Wiley Periodicals, Inc.
FAU - Doumit, Michael
AU  - Doumit M
AD  - Sydney Children's Hospital, Sydney, Australia. University of New South Wales, 
      Sydney, Australia. michael.doumit@sesiahs.health.nsw.gov.au
FAU - Krishnan, Usha
AU  - Krishnan U
FAU - Jaffe, Adam
AU  - Jaffe A
FAU - Belessis, Yvonne
AU  - Belessis Y
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20110824
PL  - United States
TA  - Pediatr Pulmonol
JT  - Pediatric pulmonology
JID - 8510590
SB  - IM
MH  - Child, Preschool
MH  - Cystic Fibrosis/complications/*therapy
MH  - *Disease Progression
MH  - Female
MH  - Gastroesophageal Reflux/etiology/*physiopathology
MH  - Head-Down Tilt/*adverse effects
MH  - Humans
MH  - Infant
MH  - Male
MH  - Monitoring, Physiologic/methods
MH  - Physical Therapy Modalities/*adverse effects
MH  - Thorax
EDAT- 2012/01/14 06:00
MHDA- 2012/05/23 06:00
CRDT- 2012/01/14 06:00
PHST- 2011/05/18 00:00 [received]
PHST- 2011/07/03 00:00 [accepted]
PHST- 2012/01/14 06:00 [entrez]
PHST- 2012/01/14 06:00 [pubmed]
PHST- 2012/05/23 06:00 [medline]
AID - 10.1002/ppul.21524 [doi]
PST - ppublish
SO  - Pediatr Pulmonol. 2012 Feb;47(2):119-24. doi: 10.1002/ppul.21524. Epub 2011 Aug 
      24.