Severe gastroesophageal reflux is associated with reduced carbon monoxide diffusing capacity

Schachter, LM; Dixon, J; Pierce, RJ; O'Brien, P

HERO ID

186707

Reference Type

Journal Article

Year

2003

Language

English

PMID

12796170

HERO ID 186707
In Press No
Year 2003
Title Severe gastroesophageal reflux is associated with reduced carbon monoxide diffusing capacity
Authors Schachter, LM; Dixon, J; Pierce, RJ; O'Brien, P
Journal Chest
Volume 123
Issue 6
Page Numbers 1932-1938
Abstract Objective. To assess whether severe gastroesophageal reflux (GER) is associated with abnormalities in lung function including measures of lung volume and gas diffusion. <br> <br>Methods: Data from 147 patients with obesity (body mass index [BMI] range, 31.7 to 70 kg/m(2)) who presented for obesity surgery was analyzed retrospectively. A questionnaire was completed preoperatively that included a history of GER, frequency and severity of symptoms, investigations, and medications used. A history of lung disease, sleep-disordered breathing, and smoking also was obtained. A physician who was blinded to lung function graded GER severity prospectively by the results of pH monitoring and/or gastroscopy, and medication use. Spirometry, lung volumes, and gas transfer were measured preoperatively. <br> <br>Results: Patients with severe GER had reduced levels of the diffusing capacity of the lung for carbon monoxide (DLCO) [21.1 mL/min/mm Hg; 95% confidence interval (CI), 18.9 to 23.2], as measured by CO transfer, compared with those patients without GER (26.3 mL/min/mm Hg; 95% CI, 24.4 to 28.2; p = 0.001). This remained significant after adjusting for age, gender, BMI, and smoking history. Gas transfer corrected for lung volume also was reduced in the group with severe GER (4.6 mL/min/mm Hg per L; 95% CI, 4.3 to 4.9) compared to the group without GER (5.3 mL/min/mm Hg per L; 95% CI, 5.1 to 5.5; p = 0.001). There was no significant difference in other measures of lung function. <br> <br>Conclusions: Severe GER is associated with an impairment of gas exchange. This may be due to microaspiration of gastric acid or fluid into the airways.
Doi 10.1378/chest.123.6.1932
Pmid 12796170
Wosid WOS:000183519000026
Is Certified Translation No
Dupe Override No
Comments N1-JunSN-0012-3692 (Print)N1-Severe gastroesophageal reflux is associated with reduced carbon monoxide diffusing capacityN1-12796170N1-Schachter, Linda MDixon, JohnPierce, Robert JO'Brien, PaulUnited StatesChestChest. 2003 Jun;123(6):1932-8.N1-engKW-AdultCarbon Monoxide/*metabolismFemaleGastroesophageal Reflux/etiology/*physiopathologyHumansMaleObesity/physiopathologyPulmonary Diffusing Capacity/*physiologyPulmonary Gas Exchange/physiologyRespiratory Function TestsRetrospective StudiesN2-OBJECTIVE: To assess whether severe gastroesophageal reflux (GER) is associated with abnormalities in lung function including measures of lung volume and gas diffusion. METHODS: Data from 147 patients with obesity (body mass index [BMI] range, 31.7 to 70 kg/m(2)) who presented for obesity surgery was analyzed retrospectively. A questionnaire was completed preoperatively that included a history of GER, frequency and severity of symptoms, investigations, and medications used. A history of lung disease, sleep-disordered breathing, and smoking also was obtained. A physician who was blinded to lung function graded GER severity prospectively by the results of pH monitoring and/or gastroscopy, and medication use. Spirometry, lung volumes, and gas transfer were measured preoperatively. RESULTS: Patients with severe GER had reduced levels of the diffusing capacity of the lung for carbon monoxide (DLCO) [21.1 mL/min/mm Hg; 95% confidence interval (CI), 18.9 to 23.2], as measured by CO transfer, compared with those patients without GER (26.3 mL/min/mm Hg; 95% CI, 24.4 to 28.2; p = 0.001). This remained significant after adjusting for age, gender, BMI, and smoking history. Gas transfer corrected for lung volume also was reduced in the group with severe GER (4.6 mL/min/mm Hg per L; 95% CI, 4.3 to 4.9) compared to the group without GER (5.3 mL/min/mm Hg per L; 95% CI, 5.1 to 5.5; p = 0.001). There was no significant difference in other measures of lung function. CONCLUSIONS: Severe GER is associated with an impairment of gas exchange. This may be due to microaspiration of gastric acid or fluid into the airways.AD-Institute for Breathing and Sleep, Austin and Repatriation Medical Centre, Heidelberg, VIC, Australia. lindams@bigpond.comUR-http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12796170ID-12
Is Public Yes
Language Text English
Keyword diffusing capacity; gastroesophageal reflux; lung function
Is Qa No