Amira Elrefaee, Abdel-Rahman A Abdel-Razek, Zeinab S Abdelkhalek, Peter Samaan, Amir Fawzy Kamal
{"title":"Incidence of gastro-esophageal reflux disease in mechanically ventilated full-term Egyptian neonates by detection of pepsin in endotracheal aspirate.","authors":"Amira Elrefaee, Abdel-Rahman A Abdel-Razek, Zeinab S Abdelkhalek, Peter Samaan, Amir Fawzy Kamal","doi":"10.5409/wjcp.v14.i3.102309","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gastroesophageal reflux disease (GERD) is common among neonates, particularly those requiring mechanical ventilation. Pepsin, a reliable marker of gastric aspiration, may help detect GER episodes in ventilated neonates and assess associated clinical outcomes.</p><p><strong>Aim: </strong>To determine the incidence of GERD, associated risk factors, and morbidities among full-term mechanically ventilated neonates by detecting pepsin in endotracheal aspirates (ETA).</p><p><strong>Methods: </strong>This study included 97 full-term neonates admitted to the neonatal intensive care unit at Cairo University Hospitals from April 2023 to March 2024. ETA samples were collected at three intervals: Immediately post-intubation (Sample A), 48 hours after intubation (Sample B), and just before extubation (Sample C). Pepsin concentration was measured using enzyme-linked immunosorbent assay. Clinical data, including hospital stay duration and feeding parameters, were correlated with pepsin levels.</p><p><strong>Results: </strong>Pepsin was detected in 76 (78.4%) of Sample A, 78 (81.3%) of Sample B, and 47 (68.1%) of Sample C. A significant positive correlation was found between pepsin levels and FiO<sub>2</sub> in Sample B (<i>r</i> = 0.203, <i>P</i> = 0.047). Prolonged hospital stay was also associated with pepsin detection in Samples B and C (<i>P</i> < 0.05). A negative correlation was observed between feeding amount and pepsin levels across all samples (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The incidence of GERD in full-term mechanically ventilated neonates is high, correlating with pepsin levels, FiO<sub>2</sub>, feeding intolerance, and hospital stay, highlighting the importance of early detection.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 3","pages":"102309"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305018/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World journal of clinical pediatrics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5409/wjcp.v14.i3.102309","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Gastroesophageal reflux disease (GERD) is common among neonates, particularly those requiring mechanical ventilation. Pepsin, a reliable marker of gastric aspiration, may help detect GER episodes in ventilated neonates and assess associated clinical outcomes.
Aim: To determine the incidence of GERD, associated risk factors, and morbidities among full-term mechanically ventilated neonates by detecting pepsin in endotracheal aspirates (ETA).
Methods: This study included 97 full-term neonates admitted to the neonatal intensive care unit at Cairo University Hospitals from April 2023 to March 2024. ETA samples were collected at three intervals: Immediately post-intubation (Sample A), 48 hours after intubation (Sample B), and just before extubation (Sample C). Pepsin concentration was measured using enzyme-linked immunosorbent assay. Clinical data, including hospital stay duration and feeding parameters, were correlated with pepsin levels.
Results: Pepsin was detected in 76 (78.4%) of Sample A, 78 (81.3%) of Sample B, and 47 (68.1%) of Sample C. A significant positive correlation was found between pepsin levels and FiO2 in Sample B (r = 0.203, P = 0.047). Prolonged hospital stay was also associated with pepsin detection in Samples B and C (P < 0.05). A negative correlation was observed between feeding amount and pepsin levels across all samples (P < 0.05).
Conclusion: The incidence of GERD in full-term mechanically ventilated neonates is high, correlating with pepsin levels, FiO2, feeding intolerance, and hospital stay, highlighting the importance of early detection.