Contrast pooling in videofluoroscopic swallowing study as a risk factor for pneumonia in children with dysphagia

Kemps, Glen; Sewitch, Maida; Birnbaum, Rena; Daniel, Sam J.

doi:10.1016/j.ijporl.2015.05.039

Cited by 5 publications

(13 citation statements)

References 14 publications

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“…It has been previously reported that up to 1% to 3% of outpatients may demonstrate thin‐liquid aspiration, and 10% to 15% may show penetration without any obvious short‐ or long‐term consequences; trace aspiration has even been reported as a normal phenomenon in otherwise healthy individuals . In contrast, some studies have reported increased risk of apparent life‐threatening events and pneumonia in children with aspiration and penetration identified on videofluoroscopic modified barium swallow study (MBSS) . In addition, a recent large retrospective review of over 12,000 children and 47 hospitals found that pediatric patients with aspiration pneumonia had longer hospitalizations, higher rates of intensive care unit admissions, higher 30‐day readmission rates, and increased hospitalization costs .…”

Section: Introductionmentioning

confidence: 99%

“…4 In contrast, some studies have reported increased risk of apparent life-threatening events and pneumonia in children with aspiration and penetration identified on videofluoroscopic modified barium swallow study (MBSS). [5][6][7] In addition, a recent large retrospective review of over 12,000 children and 47 hospitals found that pediatric patients with aspiration pneumonia had longer hospitalizations, higher rates of intensive care unit admissions, higher 30-day readmission rates, and increased hospitalization costs. 8 Although an underlying medical cause, including a neurologic, structural, or genetic comorbidity can explain the child's aspiration, often the cause remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Aspiration in the otherwise healthy Infant—Is there a natural course for improvement?

et al. 2019

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Objectives/Hypothesis Timing and indication for surgical intervention is a major challenge in managing pediatric oropharyngeal dysphagia. No study has evaluated a natural course of swallowing dysfunction in otherwise healthy infants. Our objective was to review the outcomes and time to resolution of abnormal swallow in infants with aspiration. Study Design Retrospective case series at a tertiary children's hospital. Methods Fifty patients under 1 year old with aspiration on a modified barium swallow study were included. Patients born <34 weeks, with medical or genetic comorbidities, or who underwent surgical intervention for aspiration were excluded. Patients were followed until aspiration resolved on a swallow study. Kaplan‐Meier survival analysis was performed. Results Forty patients (25 patients [50%] by 6 months, 10 [20%] by 1 year, three [6%] by 2 years, and two [4%] at the end of the follow‐up interval) were recommended a normal diet, and 10 patients (20%) were still aspirating by the end of the follow‐up interval. Median time to resolution was 202 ± 7 days (range, 19–842 days), probability 48% (95% confidence interval [CI]: 0.34‐0.62). The probability of resolution at 6 months was 46% (95% CI: 0.4‐0.68), at 1 year was 64% (95% CI: 0.51‐0.77), at 2 years was 76% (95% CI: 0.64‐0.88), and at the end of the follow‐up interval 81.3% (95% CI: 0.7‐0.92). Conclusions The majority of infants with aspiration and without any other major comorbidities improved within 1 year. Future research should be directed toward better understanding swallowing dysfunction in neurologically normal infants. Level of Evidence 4 Laryngoscope, 130:514–520, 2020

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Aspiration in the otherwise healthy Infant—Is there a natural course for improvement?

et al. 2019

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“…A total of 803 titles and abstracts were screened. Of these, 54 eligible studies were screened for full-text reviews; ultimately, 13 studies met the inclusion criteria and were included [ 6 , 7 , 11 , 12 , 13 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Thirty nine studies were excluded [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ]; the reasons for exclusion are listed in Table S1 .…”

Section: Resultsmentioning

confidence: 99%

“…The included studies were conducted in six different countries, including six studies conducted in the United States [ 6 , 13 , 25 , 26 , 28 , 29 ] and two studied conducted in each of Australia [ 7 , 32 ], Canada [ 11 , 12 ], Brazil [ 30 ], India [ 31 ], and South Korea [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…While tracheal aspiration is strongly associated with aspiration pneumonia in children [ 7 ], the association between laryngeal penetration and aspiration pneumonia remains unclear [ 8 , 9 ]. Some retrospective studies showed an increased incidence of aspiration pneumonia in children with laryngeal penetration [ 10 , 11 ], whereas other studies did not find evidence of this correlation [ 12 , 13 , 14 ]. We conducted a systematic review and meta-analysis to assess the association between laryngeal penetration and the risk of aspiration pneumonia in children with oropharyngeal dysphagia.…”

Section: Introductionmentioning

confidence: 99%

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Laryngeal Penetration and Risk of Aspiration Pneumonia in Children with Dysphagia—A Systematic Review

Imdad

Wang

Adlakha

et al. 2023

JCM

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This study was a systematic review and meta-analysis that assessed the risk of aspiration pneumonia in children with laryngeal penetration or tracheal aspiration via a video-fluoroscopic study (VFSS) and compared the results to those for children with neither condition. Systematic searches were conducted using databases, including PubMed, Cochrane Library, and Web of Science. Meta-analysis was used to obtain summary odds ratios (OR) and 95% confidence intervals (CI). The overall quality of evidence was assessed using the grading of recommendations, assessment, development, and evaluation (GRADE) criteria. In total, 13 studies were conducted with 3159 participants. Combined results from six studies showed that laryngeal penetration on VFSS may be associated with aspiration pneumonia compared to no laryngeal penetration; however, the summary estimate was imprecise and included the possibility of no association (OR 1.44, 95% CI 0.94, 2.19, evidence certainty: low). Data from seven studies showed that tracheal aspiration might be associated with aspiration pneumonia compared to no tracheal aspiration (OR 2.72, 95% CI 1.86, 3.98, evidence certainty: moderate). The association between aspiration pneumonia and laryngeal penetration through VFSS seems to be weaker than that for tracheal aspiration. Prospective cohort studies with clear definitions of laryngeal penetration and that measure clinical and patient reported outcomes are needed to further define the association between laryngeal penetration and aspiration pneumonia.

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Troubles de déglutition

Daniel¹,

Fayoux²

2017

ORL Chez l'Enfant

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Contrast pooling in videofluoroscopic swallowing study as a risk factor for pneumonia in children with dysphagia

Cited by 5 publications

References 14 publications

Aspiration in the otherwise healthy Infant—Is there a natural course for improvement?

Aspiration in the otherwise healthy Infant—Is there a natural course for improvement?

Laryngeal Penetration and Risk of Aspiration Pneumonia in Children with Dysphagia—A Systematic Review

Troubles de déglutition

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