Featured Research

from universities, journals, and other organizations

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

Date:
March 28, 2014
Source:
Nationwide Children's Hospital
Summary:
A study of 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 offer new information about the mechanisms behind ALTEs and what clinicians and parents can do to avoid them.

Sudarshan Jadcherla, MD, principal investigator in the Center for Perinatal Research at Nationwide Children's Hospital
Credit: Nationwide Children's Hospital

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."


Story Source:

The above story is based on materials provided by Nationwide Children's Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. Kathryn A. Hasenstab, Sudarshan R. Jadcherla. Respiratory Events in Infants Presenting with Apparent Life Threatening Events: Is There an Explanation from Esophageal Motility? The Journal of Pediatrics, 2014; DOI: 10.1016/j.jpeds.2014.02.003

Cite This Page:

Nationwide Children's Hospital. "Esophageal function implicated in life-threatening experiences in infants, study suggests." ScienceDaily. ScienceDaily, 28 March 2014. <www.sciencedaily.com/releases/2014/03/140328075732.htm>.
Nationwide Children's Hospital. (2014, March 28). Esophageal function implicated in life-threatening experiences in infants, study suggests. ScienceDaily. Retrieved July 30, 2014 from www.sciencedaily.com/releases/2014/03/140328075732.htm
Nationwide Children's Hospital. "Esophageal function implicated in life-threatening experiences in infants, study suggests." ScienceDaily. www.sciencedaily.com/releases/2014/03/140328075732.htm (accessed July 30, 2014).

Share This




More Health & Medicine News

Wednesday, July 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Generics Eat Into Pfizer's Sales

Generics Eat Into Pfizer's Sales

Reuters - Business Video Online (July 29, 2014) Pfizer, the world's largest drug maker, cut full-year revenue forecasts because generics could cut into sales of its anti-arthritis drug, Celebrex. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Nigeria Ups Ebola Stakes on 1st Death

Nigeria Ups Ebola Stakes on 1st Death

Reuters - Business Video Online (July 29, 2014) Nigerian authorities have shut and quarantined a Lagos hospital where a Liberian man died of the Ebola virus, the first recorded case of the highly-infectious disease in Africa's most populous economy. David Pollard reports Video provided by Reuters
Powered by NewsLook.com
Running 5 Minutes A Day Might Add Years To Your Life

Running 5 Minutes A Day Might Add Years To Your Life

Newsy (July 29, 2014) According to a new study, just five minutes of running or jogging a day could add years to your life. Video provided by Newsy
Powered by NewsLook.com
Ebola Outbreak Poses Little Threat To U.S.: CDC

Ebola Outbreak Poses Little Threat To U.S.: CDC

Newsy (July 29, 2014) The Ebola outbreak in West Africa poses little threat to Americans, according to officials with the Centers for Disease Control and Prevention. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins