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Determinants of pressure drift in Manoscan(™) esophageal high-resolution manometry system.

ABSTRACT: Manoscan(™) is one of the commonly used high-resolution manometry (HRM) systems with declared measurement accuracy of 1-2 mmHg. However, the accuracy of pressure measurements is limited by development of pressure drift (PD) throughout recording. To date, there has been no systematic investigation to identify the factors contributing to PD. The aim of the present study was to characterize the frequency and magnitude of PD in Manoscan(™) system and identify the factors contributing to PD.Records of 560 consecutive clinical esophageal HRM studies recorded by six distinct HRM catheters were retrospectively reviewed. PD was defined as the residual pressure measurement by each sensor immediately after removal of the catheter. Non-parametric locally weighted regression analysis was performed to assess the effect of duration of study, number of prior uses of a catheter, peak and average pressure exposure during a study on the PD.The majority (95%) of clinical manometry studies showed a non-negligible PD of more than 5 mmHg. The overall PD was 13 ± 5 mmHg and the sensor with greatest amount of PD showed 23 ± 12 mmHg of drift. The upper esophageal sphincter showed the highest PD. Average pressure exposure of a sensor throughout the recording was the most important predictor of PD. PD inversely correlated with number of prior uses of a catheter.The PD preferentially affects esophageal high-pressure zones, and strongly correlates with 'average pressure exposure' of a sensor during manometry. Available algorithms of the analysis software do not adequately correct the PD.

SUBMITTER: Babaei A

PROVIDER: S-EPMC4437530 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Determinants of pressure drift in Manoscan(™) esophageal high-resolution manometry system.

Babaei A A Lin E C EC Szabo A A Massey B T BT

Neurogastroenterology and motility 20141229 2

<h4>Background</h4>Manoscan(™) is one of the commonly used high-resolution manometry (HRM) systems with declared measurement accuracy of 1-2 mmHg. However, the accuracy of pressure measurements is limited by development of pressure drift (PD) throughout recording. To date, there has been no systematic investigation to identify the factors contributing to PD. The aim of the present study was to characterize the frequency and magnitude of PD in Manoscan(™) system and identify the factors contribut ...[more]

PMID: 25545126

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Project description:IntroductionGastrointestinal involvement affects 30-40% of the patients with chronic Chagas disease. Esophageal symptoms appear once the structural damage is established. Little is known about the usefulness of high resolution manometry to early identification of esophageal involvement.MethodWe performed a cross-sectional study at the Vall d'Hebron University Hospital (Barcelona, Spain) between May 2011 and April 2012. Consecutive patients diagnosed with Chagas disease in the chronic phase were offered to participate. All patients underwent a structured questionnaire about digestive symptoms, a barium esophagogram (Rezende classification) and an esophageal high resolution manometry (HRM). A control group of patients with heartburn who underwent an esophageal HRM in our hospital was selected.Results62 out of 73 patients that were included in the study fulfilled the study protocol. The median age of the Chagas disease group (CG) was 37 (IQR 32-45) years, and 42 (67.7%) patients were female. Twenty-seven (43.5%) patients had esophageal symptoms, heartburn being the most frequent. Esophagogram was abnormal in 5 (8.77%). The esophageal HRM in the CG showed a pathological motility pattern in 14 patients (22.6%). All of them had minor disorders of the peristalsis (13 with ineffective esophageal motility and 1 with fragmented peristalsis). Hypotonic lower esophageal sphincter was found more frequently in the CG than in the control group (21% vs 3.3%; p<0.01). Upper esophageal sphincter was hypertonic in 22 (35.5%) and hypotonic in 1 patient. When comparing specific manometric parameters or patterns in the CG according to the presence of symptoms or esophagogram no statistically significant association were seen, except for distal latency.ConclusionThe esophageal involvement measured by HRM in patients with chronic Chagas disease in our cohort is 22.6%. All the patients with esophageal alterations had minor disorders of the peristalsis. Symptoms and esophagogram results did not correlate with the HRM results.

Dataset Information

Determinants of pressure drift in Manoscan(™) esophageal high-resolution manometry system.

Publications

Determinants of pressure drift in Manoscan(™) esophageal high-resolution manometry system.

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