Objectives: To assess the use of ultrasound (US) to visualize and determine the correct position of a multichannel intraluminal impedance-pH probe (MII-pH). Methods: This is a monocenter study recruiting newborns who underwent MII-pH for suspicious of gastroesopahegal reflux (GER). Catheter position was based on US and was confirmed by X-ray. Moreover, the depth of the probe was compared with those calculated with several mathematical formula used for pH impedance. The US was performed using (US) system Alpinion-eCube-i7® in B-mode with linear and convex probe. US was used to evaluate the correct positioning of the MII-pH catheter before the beginning and during the MII-pH execution to evaluate any changes of the position. The results were also compared with retrospective cases collected in our center in previous years. Results: Thirty-six newborns were included. US allowed to visualize the esophageal probe in all the newborn tested. US-based positioning was correct in 100% of patients considering an error acceptance of 1 cm, and 66.7% with an error acceptance of 0.5 cm, compared to X-ray. The median duration of the US was 3.2 min (range 2.5–5.78 min), with prolonged time in crying babies. Previous cohort consisted of 35 newborns who underwent MII-pH: one patient had the probe in the respiratory tract and six patients needed new positioning of the MII-pH probe and second X-ray control because of bad positioning or accidental removal of the probe. Conclusions: US seems to be a valid alternative for the assessment of the MII-pH probe position and the identification of the pH sensor and the lower esophageal sphincter in real time. However, US expertise is needed to provide accurate results.
Ultrasonography for the positioning of esophageal multichannel intraluminal impedance/pH-metry catheter in newborns
Salvatore S.
2026-01-01
Abstract
Objectives: To assess the use of ultrasound (US) to visualize and determine the correct position of a multichannel intraluminal impedance-pH probe (MII-pH). Methods: This is a monocenter study recruiting newborns who underwent MII-pH for suspicious of gastroesopahegal reflux (GER). Catheter position was based on US and was confirmed by X-ray. Moreover, the depth of the probe was compared with those calculated with several mathematical formula used for pH impedance. The US was performed using (US) system Alpinion-eCube-i7® in B-mode with linear and convex probe. US was used to evaluate the correct positioning of the MII-pH catheter before the beginning and during the MII-pH execution to evaluate any changes of the position. The results were also compared with retrospective cases collected in our center in previous years. Results: Thirty-six newborns were included. US allowed to visualize the esophageal probe in all the newborn tested. US-based positioning was correct in 100% of patients considering an error acceptance of 1 cm, and 66.7% with an error acceptance of 0.5 cm, compared to X-ray. The median duration of the US was 3.2 min (range 2.5–5.78 min), with prolonged time in crying babies. Previous cohort consisted of 35 newborns who underwent MII-pH: one patient had the probe in the respiratory tract and six patients needed new positioning of the MII-pH probe and second X-ray control because of bad positioning or accidental removal of the probe. Conclusions: US seems to be a valid alternative for the assessment of the MII-pH probe position and the identification of the pH sensor and the lower esophageal sphincter in real time. However, US expertise is needed to provide accurate results.
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