Wenzl. Summary Bruges .docVIP

PAGE 4 PAGE 3 Wenzl, Summary Bruges 2003 Wenzl, Summary Bruges 2003 Intraluminal Impedance Dr. med. Tobias G. Wenzl, MRCPCH Kinderklinik, Universit?tsklinikum Aachen Pauwelsstr. 30, D 52074 Aachen, Germany tel +49-241-8089240 fax +49-241-8082484 email chef@ The intraluminal impedance technique (IMP) is a new method for the pH-independent detection of gastrointestinal motility. The principle of IMP is a change of electrical impedance during the passage of a bolus through a measuring segment, i.e. between two adjacent electrodes. The use of multiple segments along a catheter allows the analysis of the direction of the bolus transport. Thus, anterograde (e.g. swallowing) and retrograde (e.g. gastroesophageal reflux) bolus movements can be distinguished. In infants, a catheter with one or two pH sensitive antimony electrodes and 7 integrated impedance electrodes (Helmholtz-Institut für Biomedizinische Technik, Aachen, Germany), representing 6 measuring channels, is used. The total measuring length reaches from the cardia (channel 6) to the pharynx (channel 1), with the pH sensor being situated at the level of channel 5, approximately 3 cm above the gastroesophageal junction. Impedance and pH signals are sampled at a rate of 50 Hz per channel, as compared to 0.25 Hz in conventional pH monitoring. Situations presumably associated with esophageal motility events, such as oxygen desaturations, apneas, apparent life threatening events (ALTE), but also recurrent aspiration and bronchitis, irritability and sleep disturbances, can apparentely be induced by both an acidic or a non-acidic bolus. pH monitoring, although being a standard tool, is only able to detect acidic (pH 4) and alkaline (pH 7.5) gastroesophageal reflux (GER), leaving a method inherent diagnostic gap. Many refluxes are likely to happen in the physiological esophageal pH range (pH 5 - 6.8), and are therefore undetectable by pH monitoring. The pH-independent intraluminal impedance technique proves to