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Optimizing the high-resolution manometry (HRM) study protocol.

Publication ,  Journal Article
Patel, A; Ding, A; Mirza, F; Gyawali, CP
Published in: Neurogastroenterol Motil
February 2015

BACKGROUND: Intolerance of the esophageal manometry catheter may prolong high-resolution manometry (HRM) studies and increase patient distress. We assessed the impact of obtaining the landmark phase at the end of the study when the patient has acclimatized to the HRM catheter. METHODS: 366 patients (mean age 55.4 ± 0.8 years, 62.0% female) undergoing esophageal HRM over a 1-year period were studied. The standard protocol consisted of the landmark phase, 10 5 mL water swallows 20-30 s apart, and multiple rapid swallows where 4-6 2 mL swallows were administered in rapid succession. The modified protocol consisted of the landmark phase at the end of the study after test swallows. Study duration, technical characteristics, indications, and motor findings were compared between standard and modified protocols. KEY RESULTS: Of the 366 patients, 89.6% underwent the standard protocol (study duration 12.9 ± 0.3 min). In 10.4% with poor catheter tolerance undergoing the modified protocol, study duration was significantly longer (15.6 ± 1.0 min, p = 0.004) despite similar duration of study maneuvers. Only elevated upper esophageal sphincter basal pressures at the beginning of the study segregated modified protocol patients. The 95th percentile time to landmark phase in the standard protocol patients was 6.1 min; as many as 31.4% of modified protocol patients could not obtain their first study maneuver within this period (p = 0.0003). Interpretation was not impacted by shifting the landmark phase to the end of the study. CONCLUSIONS & INFERENCES: Modification of the HRM study protocol with the landmark phase obtained at the end of the study optimizes study duration without compromising quality.

Duke Scholars

Published In

Neurogastroenterol Motil

DOI

EISSN

1365-2982

Publication Date

February 2015

Volume

27

Issue

2

Start / End Page

300 / 304

Location

England

Related Subject Headings

  • Middle Aged
  • Manometry
  • Male
  • Humans
  • Gastroenterology & Hepatology
  • Gagging
  • Female
  • Esophageal Sphincter, Upper
  • Esophageal Motility Disorders
  • Deglutition
 

Citation

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Patel, A., Ding, A., Mirza, F., & Gyawali, C. P. (2015). Optimizing the high-resolution manometry (HRM) study protocol. Neurogastroenterol Motil, 27(2), 300–304. https://doi.org/10.1111/nmo.12494
Patel, A., A. Ding, F. Mirza, and C. P. Gyawali. “Optimizing the high-resolution manometry (HRM) study protocol.Neurogastroenterol Motil 27, no. 2 (February 2015): 300–304. https://doi.org/10.1111/nmo.12494.
Patel A, Ding A, Mirza F, Gyawali CP. Optimizing the high-resolution manometry (HRM) study protocol. Neurogastroenterol Motil. 2015 Feb;27(2):300–4.
Patel, A., et al. “Optimizing the high-resolution manometry (HRM) study protocol.Neurogastroenterol Motil, vol. 27, no. 2, Feb. 2015, pp. 300–04. Pubmed, doi:10.1111/nmo.12494.
Patel A, Ding A, Mirza F, Gyawali CP. Optimizing the high-resolution manometry (HRM) study protocol. Neurogastroenterol Motil. 2015 Feb;27(2):300–304.
Journal cover image

Published In

Neurogastroenterol Motil

DOI

EISSN

1365-2982

Publication Date

February 2015

Volume

27

Issue

2

Start / End Page

300 / 304

Location

England

Related Subject Headings

  • Middle Aged
  • Manometry
  • Male
  • Humans
  • Gastroenterology & Hepatology
  • Gagging
  • Female
  • Esophageal Sphincter, Upper
  • Esophageal Motility Disorders
  • Deglutition