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Pediatr Phys Ther. 2011 Winter;23(4):328-33. doi: 10.1097/PEP.0b013e31823565c3.

Expiratory flow increase technique and acid esophageal exposure in infants born preterm with bronchopulmonary dysplasia.

Author information

  • 1Center of Integral Attention to Women's Health, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil. liacamy@gmail.com



To determine if an expiratory flow increase technique (EFIT) is associated with acid reflux episodes in infants born preterm with bronchopulmonary dysplasia (BPD).


A crossover study was carried out. Eighteen subjects divided into 2 groups were randomly assigned to receive 2 EFIT sessions at 2 postprandial time points. Group 1 started 2 hours after feeding and group 2 started 3 hours after feeding. Esophageal acid exposure was assessed by the reflux index (RI) during EFIT and 20 minutes before EFIT by esophageal pH monitoring.


A significant reduction in the RI was observed in group 1 with EFIT performed 2 hours after feeding. Group 2 showed no significant differences in RI values before and during EFIT in both postprandial periods.


When EFIT is performed 2 and 3 hours after feeding, it is not associated with an increase in acid reflux episodes in infants born preterm with BPD.

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