TY - JOUR T1 - A survey of the investigation and management of gastro-oesophageal reflux disease on neonatal intensive care units in Britain JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2016.PA1300 VL - 48 IS - suppl 60 SP - PA1300 AU - Gwendolyn Andradi AU - Thomas Rossor AU - Ravindra Bhat AU - Anne Greenough Y1 - 2016/09/01 UR - http://erj.ersjournals.com/content/48/suppl_60/PA1300.abstract N2 - Introduction: Apnoea, desaturation and bradycardia in infants are frequently attributed to gastro-oesophageal reflux disease (GORD), and considered an indication for investigation and treatment.Investigations are limited by a paucity of normal data in infants, and poor correlation with symptoms. Despite the widespread use of anti-reflux medication there are concerns regarding the safety of acid suppression therapy and pro-kinetics.Aim: The aim of this study was to survey the variation in investigation and management of GORD on NICUs throughout the United Kingdom.Methods: A questionnaire was prepared on Survey Monkey and sent to a clinician at each of the 207 Neonatal units in the United Kingdom by email.Results: 173 neonatal units responded. The most frequently used investigation was a trial of therapy, used in 171 units, and was considered the most useful investigation in 101 units. pH studies were next most widely used, in 78 units. Upper GI contrast studies were used in 40 units and MII/pH was used in 11 units. The criteria for 'abnormal' pH and MII studies varied widely.Infants were commenced on anti-reflux medication without investigation “always” in 66 units, “often” in 61 units, “occasionally” in 40 units and “never” in 2 units.Gaviscon was used as first line treatment in 124 units, Ranitidine in 110, thickening agents in 55, proton pump inhibitors in 48, domperidone in 45 and erythromycin in 13 units.Conclusion: There is wide variety in practice across the neonatal units in the UK regarding the investigation and management of GORD. A robust approach to investigation and treatment is required to avoid unnecessary and potentially harmful medical therapy. ER -