Bravo pH Monitoring System 21 User Guide
chapter.fm 3/21/16 4:05 pm
5.5 x 7.75 inches (140 mm x 197 mm)
Placing the Capsule
1. Oral placement of the Bravo capsule can be performed either using:
a. endoscopy: using an endoscope, determine the desired location for the capsule
in the esophagus. Typically, the capsule is placed 6 cm (2.4 inches) above the
squamo-columnar junction. Measure and record the distance traveled by the
endoscope to the desired location.
b. manometry: using a transnasal manometry catheter, determine the desired
location for the capsule in the esophagus. Typically, the capsule is placed 5 cm
(2 inches) above the proximal aspect of the landmarks (LES). Use a correction
factor of approximately 4 cm to account for the longer pathway that the
manometry catheter has to travel through the nasopharynx.
2. Remove the endoscope or manometry catheter from the patient.
3. With the vacuum off, complete the following steps:
a. Remove the capsule from the buffer solution and rinse it in sterile water.
b. Mark the distance determined in step 1 on the delivery device. The depth
markings on the delivery device are indexed from the capsule’s pH sensor
(Figure 9).
c. Carefully advance the delivery device through the mouth (with the capsule
facing the patient’s tongue) to the desired location in the esophagus.
Figure 9. Capsule depth markings are indexed from pH sensor.
Caution
If lubricants are used to ease placement insertion, do not cover
the suction chamber with lubricant. This could interfere with the
attachment of the capsule.
pH sensor
pH capsule
suction chamber
depth markings
vacuum
hose
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