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Simple Formula for pH/Impedance Probe Positioning in Children—Time to Update Standard Practice?

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To develop a novel formula for pH probe placement with adequate accuracy.

Methods

Children (3–18 y) undergoing pH-metry were prospectively evaluated. Their height and corrected pH probe position under X-ray (2 vertebrae above the diaphragm) was recorded and the linear-regression analysis was performed to derive a novel formula. Its accuracy was checked on an additional group of prospectively included children. The success rate of a newly developed formula was estimated and compared to the performance of previously used formulae. The difference in the suggested placement of the probe (cm from nostrils) was calculated.

Results

Based on 670 children with pH probe placed under X-ray, the following formula was developed using the linear-regression analysis: L = 0.184x + 4.4 (cm) (L = probe placement depth, x = body height). Its accuracy was confirmed on additional 111 children resulting in almost 85% success rate. The formula showed significant difference in the suggested placement from formulae used previously: +4.9 ± 0.8 cm, +2.4 ± 0.1 cm, +0.7 ± 0.6 cm, +1.1 ± 0.4 cm, +1.8 ± 0.3 cm, +2.2 ± 0.5 cm from the one by the Strobel, Moreau, Wilson, Nowak, Staiano–Clouse formulae, and the GOSH table with the calculated success rates of 1.8%, 43.2%, 65.8%, 77.5%, 65.8% and 54.1%, respectively. A table suggesting placement depth based on the body height was developed.

Conclusion

The present formula provides 85% success of pH probe placement in children ≥ 3 y suggesting its use in routine practice. More data are needed to confirm that probe adjustment under X-ray is unnecessary.

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Funding

This study was supported by the grant of Ministry of Health of the Slovak Republic: Development of innovative diagnostic methods for the personalization of treatment of extraesophageal manifestations of gastroesophageal reflux disease; 2019/43-UKMT-6.

Author information

Authors and Affiliations

  1. National Institute of Children’s Tuberculosis and Respiratory Diseases, Dolny Smokovec, Slovakia

    Tomáš Strachan, Peter Ferenc & Peter Kunč

  2. Clinic of Internal Medicine - Gastroenterology, Jessenius Faculty of Medicine in Martin (JFM CU), JFM CU, Comenius University in Bratislava, Kollárova 2, Martin, 036 01, Slovakia

    Martin Ďuriček & Peter Bánovčin

  3. Radiology Clinic, Jessenius Faculty of Medicine in Martin (JFM CU), JFM CU, Comenius University in Bratislava, Bratislava, Slovakia

    Martin Vorčák

  4. Department of Physiology, Jessenius Faculty of Medicine in Martin (JFM CU), JFM CU, Comenius University in Bratislava, Bratislava, Slovakia

    Michal Javorka

  5. Clinic of Children TB and Respiratory Diseases, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, National Institute of Children Tuberculosis and Respiratory Diseases, Dolny Smokovec, Slovakia

    Jaroslav Fábry

Authors
  1. Tomáš Strachan
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  2. Martin Ďuriček
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  3. Peter Ferenc
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  4. Peter Kunč
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  5. Martin Vorčák
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  6. Peter Bánovčin
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  7. Michal Javorka
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  8. Jaroslav Fábry
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Contributions

All authors contributed to the conception and design of the study; TS enrolled the patients, performed pH/impedance testing, formulated the hypothesis and co-wrote the manuscript; MĎ performed data analysis, co-wrote the manuscript; PF enrolled the patients and performed pH/impedance testing; PK enrolled the patients, performed pH/impedance testing; MV performed radiological examinations; PB performed data analysis and co-wrote the manuscript; MJ performed data analysis and statistical evaluation; JF enrolled he patients and analyzed the data. MJ will act as the guarantor for this paper.

Corresponding author

Correspondence to Martin Ďuriček.

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Ethics Approval

This prospective, single-center study was performed in line with the principles of the Declaration of Helsinki. The protocol of the study was approved by the institutional ethics committee; issued on April 16th, 2014.

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Informed consent was obtained from legal guardians.

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None.

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Strachan, T., Ďuriček, M., Ferenc, P. et al. Simple Formula for pH/Impedance Probe Positioning in Children—Time to Update Standard Practice?. Indian J Pediatr 91, 131–136 (2024). https://doi.org/10.1007/s12098-022-04347-1

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  • DOI: https://doi.org/10.1007/s12098-022-04347-1

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