Use of a non-invasive accelerometric method for diagnosing gastroesophageal reflux in premature infants

OBJECTIVE: To evaluate the clinical usefulness of a non-invasive accelerometric device to diagnose GER in preterm babies. STUDY DESIGN: An accelerometer was taped over the sub-xiphoid process in 110 preterm (GA 29.6 ± 3.3 wk) infants (133 studies). Low frequency, sub-audible signals were captured via digital recording (sampling rate 200 Hz), then re-sampled (rate = 60 Hz) to create a spectrogram (focused range 0–30 Hz). Mean amplitude in the focused range was calculated. RESULTS: Of 85 studies with simultaneous pH-metry and accelerometry, 18 had concurrent positive and 23 had concurrent negative scores, 42 had negative pH scores when accelerometry was positive (≥1 µV), consistent with non-acid reflux. Eleven infants at high risk of aspiration received surgical interventions. All but 1 had negative pH scores while 10/11 had positive accelerometry. CONCLUSIONS: The non-invasiveness of this accelerometric technique allows for GER screening and for repeated testing to assess efficacy of interventions.