Oropharyngeal Aspiration and Silent Aspiration in Children

Weir, Kelly A.; McMahon, Sandra; Taylor, Simone M.; Chang, Anne B.

doi:10.1378/chest.10-1618

Cited by 171 publications

(151 citation statements)

References 51 publications

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“…Approximately 45% of normal patients had detectable aspiration during sleep, and those sleeping more soundly were found to be at greater risk (32). Neurologically normal subjects also aspirate (33). However, the amounts aspirated by neonates and infants are not known.…”

Section: Pathophysiologic Mechanisms Of Dysphagia Symptoms and Aspiramentioning

confidence: 99%

Dysphagia in the high-risk infant: potential factors and mechanisms

Jadcherla

2016

The American Journal of Clinical Nutrition

116

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Neonatal dysphagia, or abnormalities of swallowing, represent a major global problem, and consequences of dysfunctional feeding patterns carry over into infancy and toddler age groups. Growth, development, and independent feeding skills are all delayed among high-risk infants. Such a group comprises premature birth, low-birth-weight, congenital anomalies, perinatal asphyxia, postsurgical, and sepsis categories. The conflict between pathophysiologic and pragmatic feeding strategies remains a major conundrum and is largely due to a lack of validated diagnostic approaches amid heterogeneity of the patient phenotype. Thus, well-tested feeding management strategies that can be generalizable are lacking. Furthermore, the aerodigestive symptoms and signs, potential risk factors, and contributory etiologies remain nonspecific. This article presents mechanistic evidence related to the pathophysiologic basis of neonatal dysphagia as well as potential opportunities to improve feeding abilities and long-term development.Am J Clin Nutr 2016;103(Suppl):622S-8S.

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Section: Pathophysiologic Mechanisms Of Dysphagia Symptoms and Aspiramentioning

confidence: 99%

Dysphagia in the high-risk infant: potential factors and mechanisms

Jadcherla

2016

The American Journal of Clinical Nutrition

116

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“…Inferences about eating and drinking ability can be drawn from observation of subtle clinical signs. 54 Potentially harmful limitations to eating and drinking leading to aspiration of food and fluid into the lungs, visible through instrumental means such as videofluoroscopic examination of swallowing, have been documented. 1,9,55 'Silent aspiration', aspiration that takes place without the usual outward signs such as coughing, has also been documented.…”

Section: Measures -Ratio/interval Data: N=74mentioning

confidence: 99%

A systematic review of ordinal scales used to classify the eating and drinking abilities of individuals with cerebral palsy

Sellers

Pennington

Mandy

et al. 2013

Develop Med Child Neuro

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AIM The aim of this review was to examine systematically the scope, validity, and reliability of ordinal scales used to classify the eating and drinking ability of people with cerebral palsy (CP).METHOD Six electronic databases were searched to identify measures used to classify eating and drinking ability; in addition, two databases were used to track citations of key texts. The constructs assessed by each measure were examined in relation to the World Health Organization International Classification of Functioning, Disability and Health. Evidence of validity and reliability of the identified scales was appraised from peer-reviewed studies using standard criteria.RESULTS Fifteen scales were identified in 23 papers. Clinician or researcher assessment was required for 13 scales; nine scales made use of information from parents and carers through interviews or questionnaires. Eight scales used the terms mild, moderate, and severe (with varying definitions) to describe different aspects of eating and drinking impairment. There was an assessment of either content validity and/or reliability for five scales; however, none met the recommended psychometric quality standards. Individuals with cerebral palsy (CP) experience activity limitations including limitations in sitting, standing, walking, handling objects, and speaking. Impairments can also interfere with the oral functions required for eating, drinking, and swallowing, 1,2 and the ability to bring food and drink to the mouth.3 Limitations in the ability to bite, chew and swallow, and self-feed are often associated with prolonged mealtimes and loss of both food and fluid from the mouth; this can lead to insufficient food and fluid intake to ensure growth and good health, 3-7 as well as adverse respiratory consequences such as episodes of choking and aspiration. 1,[8][9][10] The prevalence of eating and drinking difficulties in individuals with CP is unclear.11 Estimates range from 27% 12 to 90%, 13 depending on the definitions and measurement tools used. It has been proposed that prevalence is related to the severity of motor impairment, 14 although eating and drinking difficulties also occur in individuals with mildly affected gross motor function. 22 The use of a consistent indicator of eating and drinking ability would enable more rigorous investigation of the prevalence of feeding disorders, and of associations between the severity of eating and drinking limitations and other health indicators such as growth, respiratory health, and gastrostomy use. 23A recent systematic review examined the psychometric performance and clinical utility of quantitative measures of oropharyngeal dysphagia in children with neurodevelopmental disabilities. 21 The aim of the current review was to examine the evidence for the validity and reliability of descriptive ordinal scales used to classify the eating and drinking ability of individuals with CP. These scales could then potentially be adopted in clinical and populationbased research. METHOD Search strategyA systematic search ...

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“…As alterações digestórias altas podem desencadear quadros de infecções respiratórias de repetição, insuficiente aporte nutricional, déficit nutricional na curva de crescimento, maior número de hospitalizações e necessidade de gastrostomia 16,17 .…”

Section: Introductionunclassified

Digestive tract neural control and gastrointestinal disorders in cerebral palsy

Araújo¹,

Silva²,

Mendes³

2012

J Pediatr (Rio J)

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Objectives: To examine the neural control of digestive tract and describe the main gastrointestinal disorders in cerebral palsy (CP), with attention to the importance of early diagnosis to an efficient interdisciplinary treatment.Sources: Systematic review of literature from 1997 to 2012 from Medline, Lilacs, Scielo, and Cochrane Library databases. The study included 70 papers, such as relevant reviews, observational studies, controlled trials, and prevalence studies. Qualitative studies were excluded. The keywords used were: cerebral palsy, dysphagia, gastroesophageal reflux disease, constipation, recurrent respiratory infections, and gastrostomy. Summary of the findings:The appropriate control of the digestive system depends on the healthy functioning and integrity of the neural system. Since CP patients have structural abnormalities of the central and peripheral nervous system, they are more likely to develop eating disorders. These range from neurological immaturity to interference in the mood and capacity of caregivers. The disease has, therefore, a multifactorial etiology. The most prevalent digestive tract disorders are dysphagia, gastroesophageal reflux disease, and constipation, with consequent recurrent respiratory infections and deleterious impact on nutritional status. Conclusions:Patients with CP can have neurological abnormalities of digestive system control; therefore, digestive problems are common. The issues raised in the present study are essential for professionals within the interdisciplinary teams that treat patients with CP, concerning the importance of comprehensive anamnesis and clinical examination, such as detailed investigation of gastrointestinal disorders. Early detection of these digestive problems may lead to more efficient rehabilitation measures in order to improve patients' quality of life.J Pediatr (Rio J). 2012;88(6):455-64: Cerebral palsy, dysphagia, gastroesophageal reflux disease, constipation. ResumoObjetivos: Abordar as peculiaridades do controle neuronal digestório e descrever as principais manifestações digestórias na paralisia cerebral, atentando-se à importância do diagnóstico precoce para intervenção interdisciplinar eficaz. Fontes dos dados:Revisão sistemática de 1997 a 2012 das bases de dados MEDLINE, LILACS, SciELO e Cochrane Library. Incluem-se 70 artigos, como revisões relevantes, estudos observacionais, ensaios clínicos e estudos de prevalência. Excluíram-se pesquisas qualitativas. Os termos pesquisados foram: paralisia cerebral, disfagia, doença do refluxo gastroesofágico, constipação intestinal, infecção respiratória e gastrostomia. Síntese dos dados:O controle adequado do trato digestório depende do funcionamento e integridade do sistema nervoso. Como indivíduos portadores de paralisia cerebral possuem anormalidades estruturais evidentes no sistema nervoso central e periférico, estão mais propensos a desenvolver distúrbios do trato digestório, com repercussões nutricionais. As alterações vão desde imaturidade neurológica até interferência do estado d...

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Oropharyngeal Aspiration and Silent Aspiration in Children

Cited by 171 publications

References 51 publications

Dysphagia in the high-risk infant: potential factors and mechanisms

Dysphagia in the high-risk infant: potential factors and mechanisms

A systematic review of ordinal scales used to classify the eating and drinking abilities of individuals with cerebral palsy

Digestive tract neural control and gastrointestinal disorders in cerebral palsy

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