Detection of a gastroesophageal reflux in the aetiology of recurrent respiratory diseases is the main indication of continuous gastroesophageal pH-metry in children. The aim of the study was to measure the diagnostic value of a daytime esophageal pH monitoring in children with recurrent respiratory diseases.
Methods: One hundred seventeen continuous esophageal pH monitoring of 5 +/- 3 year-old children presenting recurrent respiratory diseases have been reviewed. For each record, an analysis of the total record period, then the diurnal record, then the nocturnal record period was performed. The reflux index, the number of reflux per hour, and the number of long lasting reflux (> 5 min) per hour were compared between different periods (total, diurnal, and nocturnal).
Results: For the reflux index, the sensibility, the specificity, the positive predictive value and the negative predictive value of the awake period in comparison with the continuous 24 h record, considering the same standards for both periods, were 97%, 46%, 72% and 92% respectively. The ROC graph analysis showed that the cut-off adaptation for the reflux index and for the number of reflux per hour, did not allow to improve the day pH-metry performance, since sensibility and specificity moved respectively from 66% to 56% for reflux index, and from 75% to 56% for the number of reflux per hour.
Conclusion: In children explored for recurrent respiratory diseases, the night record has a bad diagnostic value and a negative diurnal record is strongly predictive of absence of pathological gastroesophageal reflux in these children. Because of the absence of paediatric specific standards for this disorder, it is not possible to reduce the recording time to the diurnal period.