What are the apparent life-threatening events (ALTEs) associated with pediatric gastroesophageal reflux disease (GERD)?

Updated: Mar 14, 2019
  • Author: Steven M Schwarz, MD, FAAP, FACN, AGAF; Chief Editor: Carmen Cuffari, MD  more...
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ALTEs that involve apnea associated with bradycardia, pallor, and/or cyanosis have been linked to gastroesophageal reflux, especially in premature infants. In these events, reflux into the hypopharynx is postulated to lead to laryngospasm and subsequent obstructive apnea. However, data suggest only a weak association between these phenomena. Any such relationship can be objectively determined only by esophageal pH monitoring performed in conjunction with pneumography and either nasal thermistor or pulse oximetry recording.

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