A Patient- and Family-Centered Model of Feeding and Swallowing Management for Children With Tracheostomies

Jackson, Arwen; Harendt, Shaunda; Baker, Christopher D.

doi:10.1044/persp3.sig13.101

Cited by 3 publications

(10 citation statements)

References 48 publications

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“…29,30 The gastro-esophageal reflux (GER) disease, dysphagia, delayed gastric emptying and constipation are the most common GI problems of the children with tracheostomy on MV. [31][32][33] 2.1 | Ger disease impairement. [35][36][37][38] In the study of mechanical ventilated critically ill patients, the basal LES pressure was found to be low and a minimal increase in abdominal pressure due to suctioning, straining, coughing may cause frequent reflux episodes.…”

Section: Gi Problems In Children On Himvmentioning

confidence: 99%

“…Factors that may affect feeding of the children with tracheostomy are given in Table 8. 33,52 Swallowing is a complex process which is controlled by brain stem, cortex and enteric nervous system that innervates esophagus smooth muscles. There are three phases of swallowing.…”

Section: Dysphagiamentioning

confidence: 99%

“…Flexible Endoscopic Evaluation of Swallowing (FEES) and Videofluoroscopy (VFS) are the gold standart methods to evaluate swallowing dysfunction. 33,53,54 Pharyngeal phase of swallowing, penetration and aspiration can be detected by FEES. A speech and language therapist (SLT) and a pediatric Ear-Nose-Throat (ENT) specialist can perform FEES.…”

Section: Dysphagiamentioning

confidence: 99%

“…Swallowing ability of the different consistencies of foods such as liquids, thickened liquids, purees and solids can be determined. 33,53,54 Aspiration is a major problem that complicates the clinical status and respiratory condition of these children. Aspiration may lead hypoxemia, cough, respiratory distress or it may be silent.…”

Section: Dysphagiamentioning

confidence: 99%

“…Untreated aspiration may result in bronchiectasis and decreased lung function. 33 On the contrary, in recent years many centers change their feeding strategy to giving heavy-thickened liquids even if there is aspiration and/or penetration on VFSS. Particularly in patients with tracheostomy it is considered to be safer due to the chance of removing aspirates through the tracheostomy tube.…”

Section: Dysphagiamentioning

confidence: 99%

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Management of gastrointestinal and nutritional problems in children on home invasive mechanical ventilation

Tuna Kirsaçlioğlu

2023

Pediatric Pulmonology

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In recent decades, the patient survival is increased due to advances in intensive care units and development of modern mechanic ventilators. Unfortunately, it is not always possible to wean these children from mechanical ventilation. Recently, after placement a tracheostomy tube, these children can be supported at home with noninvasive or invasive mechanical ventilation. Most of the children who need ventilation support at home have neurological impairment. The nutritional issues and gastrointestinal (GI) complications are well defined in critically ill patients, but there are very limited studies on children with tracheostomy. Considering that majority of the patients have neuromuscular disorders, the nutritional and GI problems of the children with tracheostomy are discussed in light of the knowledge of critically ill patients.

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Section: Gi Problems In Children On Himvmentioning

confidence: 99%

Section: Dysphagiamentioning

confidence: 99%

Section: Dysphagiamentioning

confidence: 99%

Section: Dysphagiamentioning

confidence: 99%

Section: Dysphagiamentioning

confidence: 99%

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Management of gastrointestinal and nutritional problems in children on home invasive mechanical ventilation

Tuna Kirsaçlioğlu

2023

Pediatric Pulmonology

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Retraction: Servicing the Senior Swallow: A Family-Centered Private Practice Model of Service Delivery

McCoy¹

2021

Perspect ASHA SIGs

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Purpose Person-centered care shifts the focus of treatment away from the traditional medical model and moves toward personal choice and autonomy for people receiving health services. Older adults remain a priority for person-centered care because they are more likely to have complex care needs than younger individuals. Even more specifically, the assessment and treatment of swallowing disorders are often thought of in terms of setting-specific (i.e., acute care, skilled nursing, home health, etc.), but the management of dysphagia in older adults should be considered as a continuum of care from the intensive care unit to the outpatient multidisciplinary clinic. In order to establish a framework for the management of swallowing in older adults, clinicians must work collaboratively with a multidisciplinary team using current evidence to guide clinical practice. Private practitioners must think critically not only about the interplay between the components of the evidence-based practice treatment triad but also about the broader impact of dysphagia on caregivers and families. The physical health and quality of life of both the caregiver and the person receiving care are interdependent. Conclusion Effective treatment includes consideration of not only the patient but also others, as caregivers play an important role in the recovery process of the patient with swallowing disorders.

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A Literature Review of Feeding Disorders in Children with Tracheostomies and Ventilators

Sobotka¹,

Laudon²,

Jackson³

et al. 2022

Pediatr Ann

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Feeding disorders and gastrostomy use are highly prevalent in children with invasive mechanical ventilation (IMV) due to both common risk factors (eg, prematurity, neurological disorders) and resultant experiential deprivation (eg, long hospitalizations, delayed feeding experiences). Feeding in children with IMV is complicated by the presence of a tracheostomy, lung vulnerability, and medical complexity. The potential comorbidity of swallowing difficulties (dysphagia) and atypical early feeding experiences can result in complex feeding disorders. In this review of pediatric feeding disorders in children with invasive mechanical ventilation (IMV), we identify gaps in clinical translational research for this patient population and opportunities for improving evidence-based management. To improve long-term feeding outcomes and maximize oral feeding in this vulnerable population, children would benefit from earlier feeding opportunities during critical developmental windows, standardized protocols for advancing oral feeding, and involvement of intensive, comprehensive therapies throughout hospitalizations and early childhood. [ Pediatr Ann . 2022;51(7):e291–e296.]

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A Patient- and Family-Centered Model of Feeding and Swallowing Management for Children With Tracheostomies

Cited by 3 publications

References 48 publications

Management of gastrointestinal and nutritional problems in children on home invasive mechanical ventilation

Management of gastrointestinal and nutritional problems in children on home invasive mechanical ventilation

Retraction: Servicing the Senior Swallow: A Family-Centered Private Practice Model of Service Delivery

A Literature Review of Feeding Disorders in Children with Tracheostomies and Ventilators

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