{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:26:40Z","timestamp":1784028400892,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"ESPGHAN International Networking Grant"},{"name":"Amsterdam Gastroenterology and Metabolism talent development program"},{"name":"College of Medicine and Public Health, Flinders University"},{"name":"National Health & Medical Research Council Senior Research Fellowship"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>High\u2010resolution esophageal manometry (HREM), derived esophageal pressure topography metrics (EPT), integrated relaxation pressure (IRP), and distal latency (DL) are influenced by age and size. Combined pressure and intraluminal impedance also allow derivation of metrics that define distension pressure and bolus flow timing. We prospectively investigated the effects of esophageal length on these metrics to determine whether adjustment strategies are required for children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010five children (12.3\u00a0\u00b1\u00a04.5\u00a0years) referred for HREM, and 30 healthy adult volunteers (46.9\u00a0\u00b1\u00a03.8\u00a0years) were included. Studies were performed using the MMS system and a standardized protocol including 10\u00a0\u00d7\u00a05\u00a0mL thin liquid bolus swallows (SBM kit, Trisco Foods) and analyzed via Swallow Gateway (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.swallowgateway.com\">www.swallowgateway.com<\/jats:ext-link>). Esophageal distension pressures and swallow latencies were determined in addition to EGJ resting pressure and standard EPT metrics. Effects of esophageal length were examined using partial correlation, correcting for age. Adult\u2010derived upper limits were adjusted for length using the slopes of the identified linear equations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Mean esophageal length in children was 16.8\u00a0\u00b1\u00a02.8\u00a0cm and correlated significantly with age (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.787, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.000). Shorter length correlated with higher EGJ resting pressure and 4\u2010s integrated relaxation pressures (IRP), distension pressures, and shorter contraction latencies. Ten patients had an IRP above the adult upper limit. Adjustment for esophageal length reduced the number of patients with elevated IRP to three.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>We prospectively confirmed that certain EPT metrics, as well as potential useful adjunct pressure\u2010impedance measures such as distension pressure, are substantially influenced by esophageal length and require adjusted diagnostic thresholds specifically for children.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13721","type":"journal-article","created":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T05:41:47Z","timestamp":1569908507000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["High\u2010resolution esophageal manometry in pediatrics: Effect of esophageal length on diagnostic measures"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9297-4790","authenticated-orcid":false,"given":"Maartje M. J.","family":"Singendonk","sequence":"first","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition Emma Children's Hospital Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara F.","family":"Ferris","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health Flinders University Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"McCall","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Women's and Children's Hospital Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Seiboth","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Women's and Children's Hospital Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Lowe","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Women's and Children's Hospital Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Moore","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Women's and Children's Hospital Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Hammond","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Women's and Children's Hospital Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Couper","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Women's and Children's Hospital Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rammy","family":"Abu\u2010Assi","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Women's and Children's Hospital Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Cock","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology &amp; Hepatology Southern Adelaide Local Health Network Bedford Park South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Benninga","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition Emma Children's Hospital Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8112-8414","authenticated-orcid":false,"given":"Michiel P.","family":"van Wijk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology and Nutrition Emma Children's Hospital Amsterdam UMC University of Amsterdam Amsterdam The Netherlands"},{"name":"Department of Pediatric Gastroenterology Emma Children's Hospital Amsterdam UMC\u2013VU University Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5108-7378","authenticated-orcid":false,"given":"Taher I.","family":"Omari","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health Flinders University Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"In Association with the European Society for Pediatric Gastroenterology, Hepatology, Nutrition (ESPGHAN) Pediatric Motility Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12488"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13113"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12397"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.656"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/dote.12300"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640613492157"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12308"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-017-3000-3"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.12.002"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001647"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/2050571X.2018.1535564"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13452"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640618798487"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(18)33297-9"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13321"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-017-0552-2"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002080"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2012.01931.x"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.02.051"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00011.2005"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13277"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12267"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13104"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12167"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00091.2017"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.131"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3182952e50"}],"container-title":["Neurogastroenterology &amp; 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