World J Clin Pediatr. 2025 Sep 9;14(3):102309. doi: 10.5409/wjcp.v14.i3.102309. eCollection 2025 Sep 9.
ABSTRACT
BACKGROUND: Gastroesophageal reflux disease (GERD) is common among neonates, particularly those requiring mechanical ventilation. Pepsin, a reliable marker of gastric aspiration, may help detect GER episodes in ventilated neonates and assess associated clinical outcomes.
AIM: To determine the incidence of GERD, associated risk factors, and morbidities among full-term mechanically ventilated neonates by detecting pepsin in endotracheal aspirates (ETA).
METHODS: This study included 97 full-term neonates admitted to the neonatal intensive care unit at Cairo University Hospitals from April 2023 to March 2024. ETA samples were collected at three intervals: Immediately post-intubation (Sample A), 48 hours after intubation (Sample B), and just before extubation (Sample C). Pepsin concentration was measured using enzyme-linked immunosorbent assay. Clinical data, including hospital stay duration and feeding parameters, were correlated with pepsin levels.
RESULTS: Pepsin was detected in 76 (78.4%) of Sample A, 78 (81.3%) of Sample B, and 47 (68.1%) of Sample C. A significant positive correlation was found between pepsin levels and FiO2 in Sample B (r = 0.203, P = 0.047). Prolonged hospital stay was also associated with pepsin detection in Samples B and C (P < 0.05). A negative correlation was observed between feeding amount and pepsin levels across all samples (P < 0.05).
CONCLUSION: The incidence of GERD in full-term mechanically ventilated neonates is high, correlating with pepsin levels, FiO2, feeding intolerance, and hospital stay, highlighting the importance of early detection.
PMID:40881089 | PMC:PMC12305018 | DOI:10.5409/wjcp.v14.i3.102309
