Dorfman Lev, El-Chammas Khalil, Fei Lin, Kaul Ajay
Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Pediatr Res. 2025 Apr 28. doi: 10.1038/s41390-025-04042-9.
Antroduodenal (ADM) and colonic (CM) manometries are performed in pediatric patients to evaluate gastrointestinal motility disorders. While minimal standards for performing ADM and CM have been published, there are no standardized protocols for performance of these studies. We aimed to evaluate the diversity in ADM and CM protocols in pediatric centers worldwide.
A cross-sectional study using an anonymous survey was conducted among pediatric centers worldwide comparing US and non-US centers.
Responses were received from 37 pediatric centers. ADM: 17 (45.9%) centers perform next-day and 14 (37.8%) centers perform same-day studies. Study length ranges from 4 to 24 hours. Erythromycin stimulation is implemented by 29/33 (87.9%), azithromycin by 15/33 (45.5%) and octreotide by 7/33 (21.2%) centers. US centers perform more pharmacological stimulations (30/31 (96.8%) vs. 3/6 (50%), p = 0.0018), while non-US centers conduct longer studies (15.3 hours vs. 7.4 hours, p = 0.0291). CM: 17 (45.9%) centers perform same-day studies with length from 4 to 24 hours, and 89.2% perform pharmacological stimulation, all using bisacodyl.
Significant variability exists in ADM and CM protocols among pediatric centers, affecting study length and pharmacological stimulation. Universal standardized guidelines are needed to ensure uniformity in the performance and interpretation of these studies.
Pediatric gastroenterological societies set minimal standards for antroduodenal (ADM) and colonic (CM) manometry studies, allowing variability in timing, fasting, postprandial phases, and provocation tests. Protocol variability among pediatric centers worldwide has not been previously assessed. This study offers a real-life overview of ADM and CM practices in pediatric centers worldwide, highlighting the need for standardized guidelines due to observed variability in timing, duration, and pharmacologic stimulation. The lack of standardization affects study interpretation and underscores the importance of developing universal guidelines.
在儿科患者中进行十二指肠（ADM）和结肠（CM）测压以评估胃肠动力障碍。虽然已经公布了进行ADM和CM的最低标准，但尚无这些研究的标准化方案。我们旨在评估全球儿科中心ADM和CM方案的多样性。
在全球儿科中心进行了一项使用匿名调查的横断面研究，比较了美国和非美国中心。
收到了37个儿科中心的回复。ADM：17个（45.9%）中心进行次日检查，14个（37.8%）中心进行当日检查。研究时长从4小时到24小时不等。29/33（87.9%）的中心采用红霉素刺激，15/33（45.5%）的中心采用阿奇霉素，7/33（21.2%）的中心采用奥曲肽。美国中心进行更多的药物刺激（30/31（96.8%）对3/6（50%），p = 0.0018），而非美国中心进行更长时间的研究（15.3小时对7.4小时，p = 0.0291）。CM：17个（45.9%）中心进行当日检查，时长从4小时到24小时不等，89.2%进行药物刺激，均使用比沙可啶。
儿科中心之间ADM和CM方案存在显著差异，影响研究时长和药物刺激。需要通用的标准化指南以确保这些研究在实施和解读上的一致性。
儿科胃肠病学会为十二指肠（ADM）和结肠（CM）测压研究设定了最低标准，允许在时间安排、禁食、餐后阶段和激发试验方面存在差异。此前尚未评估全球儿科中心之间方案的差异。本研究提供了全球儿科中心ADM和CM实践的实际概况，强调由于在时间、时长和药物刺激方面观察到的差异，需要标准化指南。缺乏标准化会影响研究解读，并凸显制定通用指南的重要性。
