AN INFANT WITH ASTHMA ASSOCIATED WITH GASTROESOPHAGEAL REFLUX:USEFULNESS OF SIMULTANEOUS MONITORING OF 24-HOURS pH OF DISTAL ESOPHAGUS AND SpO2 BY PULSE OXIMETER

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In this case, a year and four months old boy, showed recurrent wheezing in spite of the administration of beta2-stimulants. Then we examined the relationship between gastroesophageal reflux (GER) and asthma. Esophagram demonstrated no regurgitation of barium from stomach to esophagus. However the score of 24-houmsr pH monitoring of the distal esophagus was 57.1 (mean+2SD of controls=15.44), lower esophageal sphincter pressure was 80mmH2O (mean+2SD of controls=130mmH2O), lower esophageal sphincter length wan 9.2mm (mean+2SD of controls=10.0mm). These data resulted in the diagnosis of GER. Furthermore, the simultaneous monitoring of SpO2 by pulse oximeter and 24-hours pH of distal esophagus demonstrated the synchronized decrease of pH of esophagus and SpO2 during wheezing. The relationship between GER and asthma was shown in this case. A decrease up to 34., 7 of score of 24-hourspH monitoring was observed afteroral administration of omeprazole (proton-pump inhibitor) and further improvement of the score (28.5) was gained by combined administration of omeprazole and antacid. Then his asthma was also well controlled. It was suggested that the simultaneous monitoring of 24-hours pH monitoring of the distal esophagus and SpO2 by puls oximeter is useful for the assessment of the relationship between GER and asthma. Omeprazole is one of the effective treatment for asthma in which GER is involved.
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