Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Esophageal function implicated in life-threatening experiences in infants, study suggests

28.03.2014

About 1 percent of all emergency room visits are prompted by near-death experiences in infants, such as extended periods without breathing or sudden changes in skin pallor or muscle tone. What causes these frightening experiences is often unknown, but the result can be long hospital stays and neurological impairment.

Now, a study of these apparent life-threatening events — called ALTEs for short — suggests that infants who experience them have abnormal regulation of esophageal and airway function compared to healthy babies. The findings, published online March 28 in the Journal of Pediatrics by a team in The Research Institute at Nationwide Children's Hospital, offer new information about the mechanisms behind ALTEs and what clinicians and parents can do to avoid them.

The research, led by Sudarshan Jadcherla, MD, principal investigator in the Center for Perinatal Research, compared 10 infants who experienced an ALTE and 10 healthy babies using innovative tools that track the concurrent functions of the infants' upper digestive tracts and airways. They found that infants with a previous near-death experience were more likely to have pauses in breathing, gasping breaths, less effective upper airway protection, delays in clearing their airways and difficulty coordinating swallowing and respiratory interactions.

"Previously, these life-threatening events were thought to be due to gastroesophageal reflux disease (GERD), and acid-suppressive treatment for that was often begun," says Dr. Jadcherla, who is also the director of the Neonatal and Infant Feeding Disorders Program and the Neonatal Aerodigestive Pulmonary Program at Nationwide Children's. "But our study identifies the dysfunctions in the aerodigestive tract — instead of GERD-centered mechanisms — as the real therapeutic targets for these babies."

Evaluating and accommodating these problems of esophageal function instead of initiating GERD medication (unless there is specific evidence of the condition) may be the key to preventing future near-death events for at-risk infants, he suggests.

"These infants' respiratory limitations are generally due to immaturity of functional neural networks involved with swallowing and airway safety," Dr. Jadcherla says. "The treatment for managing them is patience and perseverance with the quality of oral feeding."

The researchers used manometry — a pressure-sensitive tube inserted through the nose and into the esophagus — to measure muscle contractions, swallowing, reflex strength and gastroesophageal reflux in all 20 participants. Infants with ALTE were slower to get back to normal aerodigestive regulation after an esophageal event (such as swallowing or gastroesophageal reflux), with a higher proportion of failed muscle contraction in the esophagus, more frequent episodes of pauses in breathing and more gasping breaths.

"For infants with esophageal function difficulties, proper positioning, proper feeding methods, taking time with the baby during oral feeding and allowing time for maturation to heal their problems are essential to protecting these babies from ALTEs," Dr. Jadcherla says. "We need to be patient in the care of such vulnerable little patients."

Understanding the causes of and treatments for near-death events in infants may also shed light on aerodigestive protective mechanisms implicated in some cases of sudden infant death syndrome, or SIDS.

"Gasping can be a mechanism for self-resuscitation when associated with swallowing, restoring respiratory normalcy," says Dr. Jadcherla, also a professor of pediatrics at The Ohio State University College of Medicine. "Although there can be many theories for death in any given infant with SIDS, the precise mechanisms or therapeutic targets in such infants when they are alive remain elusive. Understanding the aerodigestive mechanisms in the context of airway protection and feeding safety may offer hope."

Gina Bericchia | EurekAlert!

Further reports about: SIDS airway death esophageal function healthy infants life-threatening mechanism protective

More articles from Health and Medicine:

nachricht Nanotubes are beacons in cancer-imaging technique
23.05.2016 | Rice University

nachricht More light on cancer
20.05.2016 | Lomonosov Moscow State University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Computational high-throughput screening finds hard magnets containing less rare earth elements

Permanent magnets are very important for technologies of the future like electromobility and renewable energy, and rare earth elements (REE) are necessary for their manufacture. The Fraunhofer Institute for Mechanics of Materials IWM in Freiburg, Germany, has now succeeded in identifying promising approaches and materials for new permanent magnets through use of an in-house simulation process based on high-throughput screening (HTS). The team was able to improve magnetic properties this way and at the same time replaced REE with elements that are less expensive and readily available. The results were published in the online technical journal “Scientific Reports”.

The starting point for IWM researchers Wolfgang Körner, Georg Krugel, and Christian Elsässer was a neodymium-iron-nitrogen compound based on a type of...

Im Focus: Atomic precision: technologies for the next-but-one generation of microchips

In the Beyond EUV project, the Fraunhofer Institutes for Laser Technology ILT in Aachen and for Applied Optics and Precision Engineering IOF in Jena are developing key technologies for the manufacture of a new generation of microchips using EUV radiation at a wavelength of 6.7 nm. The resulting structures are barely thicker than single atoms, and they make it possible to produce extremely integrated circuits for such items as wearables or mind-controlled prosthetic limbs.

In 1965 Gordon Moore formulated the law that came to be named after him, which states that the complexity of integrated circuits doubles every one to two...

Im Focus: Researchers demonstrate size quantization of Dirac fermions in graphene

Characterization of high-quality material reveals important details relevant to next generation nanoelectronic devices

Quantum mechanics is the field of physics governing the behavior of things on atomic scales, where things work very differently from our everyday world.

Im Focus: Graphene: A quantum of current

When current comes in discrete packages: Viennese scientists unravel the quantum properties of the carbon material graphene

In 2010 the Nobel Prize in physics was awarded for the discovery of the exceptional material graphene, which consists of a single layer of carbon atoms...

Im Focus: Transparent - Flexible - Printable: Key technologies for tomorrow’s displays

The trend-forward world of display technology relies on innovative materials and novel approaches to steadily advance the visual experience, for example through higher pixel densities, better contrast, larger formats or user-friendler design. Fraunhofer ISC’s newly developed materials for optics and electronics now broaden the application potential of next generation displays. Learn about lower cost-effective wet-chemical printing procedures and the new materials at the Fraunhofer ISC booth # 1021 in North Hall D during the SID International Symposium on Information Display held from 22 to 27 May 2016 at San Francisco’s Moscone Center.

Economical processing

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Networking 4.0: International Laser Technology Congress AKL’16 Shows New Ways of Cooperations

24.05.2016 | Event News

Challenges of rural labor markets

20.05.2016 | Event News

International expert meeting “Health Business Connect” in France

19.05.2016 | Event News

 
Latest News

LZH shows the potential of the laser for industrial manufacturing at the LASYS 2016

25.05.2016 | Trade Fair News

Great apes communicate cooperatively

25.05.2016 | Life Sciences

Thermo-Optical Measuring method (TOM) could save several million tons of CO2 in coal-fired plants

25.05.2016 | Power and Electrical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>