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Table 1 Variables monitored during HRIM study in critically ill patients

From: Characterization of esophageal motor activity, gastroesophageal reflux, and evaluation of prokinetic effectiveness in mechanically ventilated critically ill patients: a high-resolution impedance manometry study

Clinical parameters:

Mean arterial pressure, heart rate, respiratory rate, oxygen saturation, body temperature (every hour), intraabdominal pressure (2 × during the study), ventilator setting

Laboratory parameters:

Arterial lactate, hemoglobin, creatinine, bilirubin, albumin, CRP, INR at 5:00, glycemia at 6:00, 9:00, 12:00

HRM resting parameters

Tonus of LESa

Inspiratory EGJ pressure (EGJP-insp). Average maximal inspiratory EGJ pressure for three respiratory cyclesa

Expiratory EGJ pressure (EGJP-exp). Average EGJ pressure midway between inspirations for the same three respiratory cyclesa

Esophagogastric junction contractile integral (EGJ-CI)a

HRM dynamic parameters

Number of dry swallows and panesophageal secondary peristalsis/1 h

Distal contractile integral (DCI)

% of failed peristalsis

% of panesophageal pressurizations

% of premature contractions

% of double-peaked waves

Integrated relaxation time (IRP)

Intrabolus pressure (IBP)

Impedance

Number of liquid, mixed, and gaseous reflux episodes (defined as a sequential oral progressive decrease/increase in impedance below/above 40% baseline values distally with a retrograde propagation by at least 2 additional proximal observed fields in the absence of explanatory peristaltic component (median/hour of study)

Number of distal and proximal refluxes

Origin mechanism for each reflux episode:

  Swallow associated reflux (reflux within 10 s of finished swallow)

  Panesophageal secondary peristalsis associated reflux (reflux having TLESR character occurring within 10 s after panesophageal secondary peristalsis)

  Partial esophageal secondary peristalsis associated reflux (reflux having TLESR character occurring within 10 s after the non-swallowing partial esophageal activity)

  TLESR—reflux associated with a temporary decrease in LES tone below 5 mmHg, without association with dry swallow, esophageal secondary peristalsis or cough)

  Cough associated reflux (reflux within 30 s of cough episode/MV interference)

  Absence of the LES tone (reflux at low LES tone below 5 mmHg, without an association with esophageal contraction or cough)

  Panesophageal secondary peristalsis, partial esophageal secondary peristalsis in the close post-refulx period (within 10s of reflux) 

  Cough

  Agitation

  1. HRM high-resolution manometry, LES lower esophageal sphincter, EGJ esophagogastric junction, TLESR transient lower esophageal sphincter relaxation, MV mechanical ventilation
  2. aMeasured 3 times in each study hour and expressed as the median for a particular study period