352 DECREASED PLASMA BETA ENDORPHINS LEVELS (BE) AFTER TREATMENT OF GASTRO OESOPHAGEAL REFLUX (GER) IN BABIES ADMITTED FOR ACUTE LIFE THREATENING

Abstract

GER frequent during the first months of life is considered as a risk factor for ALTE or SIDS. In a previous work we have shown the presence of an increased plasma BE levels in babies with ALTE and GER. In 14 patients admitted for ALTE., 10 had marked GER. BE levels were determined at admission in all subjects and after treatment in 9. Ventilation and occlusion pressure at 100 ms (P0.1) were measured with a face mask, pneumotachograph and pressure transducer during natural sleep at the same time. On admission BE was increased significantly in babies with GER (n=10) when compared to babies without GER (repectively 58.6 ± 18.9 vs 28 ± 15.8 pg/ml, p < 0.025). In the 9 cases studied twice, 6 had GER at admission. In 4 of them GER was resolved after treatment and BE levels dropped from 53 ± 7 to 17±2 pg/ml. In the 2 cases without GER improvement. BE levels remained stable (68 vs 62 and 67 vs 46 pg/ml). Of the 3 cases with no significant GER at the first study one was highly agitated and another showed a long episode of GER; in these 2 patients BE levels were increased al the 2nd determination (14 to 50 and 18 to 120 pg/ml).

None of the ventilatory parameters (VE, RR, VT, Ti, Tc or P 0.1) correlated with beta endorphin levels. p 0.1 was within the normal range (4.58 ± 1.3 cm H₂O). In 2 cases with P 0.1 below 3 cmH2O (19 and 2.9 cm H₂O, BE levels were elevated., respectively 58 and 64 pg/ml. High levels of BE associated to GER are reduced by GER treatment. However, an influence of increased levels of BE on ventilation could not be demonstrated. (Reseau INSERM 9012)

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