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. 2014 Sep 16;9(9):e107736.
doi: 10.1371/journal.pone.0107736. eCollection 2014.

Nasal continuous positive airway pressure inhibits gastroesophageal reflux in newborn lambs

Djamal Djeddi  1 , Danny Cantin  2 , Nathalie Samson  2 , Jean-Paul Praud  2
Affiliations

Nasal continuous positive airway pressure inhibits gastroesophageal reflux in newborn lambs

Djamal Djeddi et al. PLoS One. .

Erratum in

  • PLoS One. 2014;9(12):e115157

Abstract

Background: Using esophageal pHmetry, nasal CPAP (nCPAP) has been shown to decrease acid gastroesophageal reflux (GER) in adult humans. Although both GER (mainly non-acid) and nCPAP use are very frequent in newborns, the effect of nCPAP on GER in early life is unknown. Having recently shown that the newborn lamb is a unique model for studying neonatal GER, our main objective was to assess the effect of nCPAP on GER in newborn lambs.

Methods: Eight newborn lambs, aged 2-3 days, were studied. Continuous esophageal pH-Impedance monitoring and polysomnography were performed for six hours during both spontaneous breathing and nCPAP application at 6 cmH2O (nCPAP(6)), in a randomized order. Results were compared in the two experimental conditions, as well as without CPAP during the following 6 hours.

Results: i) nCPAP(6) virtually abolished GER [mean ± SD reflux number for 6 h = 9.1 ± 8.6 without nCPAP(6) vs. 0.6 ± 1 with nCPAP(6), P<0.05]; ii) GER number was also reduced during the 6 h-period following nCPAP(6) application (18 ± 16 without nCPAP(6) vs. 7 ± 8.1 with nCPAP(6), P<0.05); iii) nCPAP(6) decreased the depth and duration of lower esophageal sphincter relaxation.

Conclusions: nCPAP inhibits GER in the newborn lamb. Further clinical studies using different levels of nasal CPAP are needed to confirm this result in human infants.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Number of reflux events for no CPAP and nCPAP6 conditions in newborn lambs during the six-hour recording period while in the sling.
Abbreviations: nCPAP6 =  nasal CPAP+6 cmH2O.
Figure 2
Figure 2. Number of reflux events during the 6 h-period following recording in the sling with either nCPAP6 application (right) or control condition (left).
The overall greater number in refluxes compared to figure 1 is related to the lamb being now allowed to move and feed at will in the Plexiglas chamber. Abbreviations: nCPAP6 =  nasal CPAP+6 cmH2O.
See this image and copyright information in PMC

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