Valores normais da junção esofagogástrica em repouso e durante manobras inspiratórias padronizadas pela manometria de alta resolução

Abstract

The competence of JEG depends on the integrity and interaction of important requirements, such as: intrinsic lower esophageal sphincter, extrinsic compression of the LES by the crural diaphragm, intra-abdominal localization of the LES, JEG compliance, brainstem esophageal ligament integrity and His. Changes in the contraction of the diaphragmatic crème generate increases in the pressure of the esophagastric junction. During deep inspiration there is increased pressure, which ranges from 50 to 150 mmHg. Objectives: To evaluate JEG motor function during resting breathing and during standard inspiratory maneuvers of Time Controlled Deep Respiration Maneuver (TCDRM) and Threshold Maneuver in healthy volunteers by High Resolution Esophageal Manometry (HRM). Method: The sample consisted of 31 healthy asymptomatic volunteers who performed HRM for the measurement of the parameters related to the contribution of the crural diaphragm to the JEG pressure in addition to the JEG and IES motility variables according to the Chicago Classification version 3.0. Results: the mean age of the volunteers was 34.14 ± 11.19 years. The results were presented by gender and age group. The mean weight was 69.75 ± 14.33 kg. The mean BMI of the 31 volunteers was 25.71 ± 4.45 Kgcm2 with a median of 25.9 Kgcm2. The median and median Pimax were -99.66 ± 29.35 cmH2O and -97.05 cmH2O. The variables JEG Activity and CI-JEG increased as there was an increase in inspiratory load, there was an exception for this increase when the load was limited to TH48. Pimax did not correlate with the CI-JEG, AT-JEG and Pmax variables in JEG. The axial displacement (DS) correlated with the TH12 maneuver. The mean Integral Relaxation Pressure (IRP) was 9.91 ± 5.37 mmHg. The mean DL found in the study was 6.83 ± 1.22s. Conclusion: Pimáx, despite being an easy measure to reproduce, did not correlate with the following variables: axial displacement (DS), maximum pressure in JEG, CI-JEG and AT-JEG. Axial displacement correlated with JEG Activity during TH12 cmH2O Maneuver. In healthy subjects, the crural diaphragm has been shown to resist inspiratory loading increments. Keywords: Diaphragm. Manometry. Esophagogastric junction.