Swallowing dysfunction in infants less than 1 year of age

Mercado-Deane, M. G.; Burton, Edward M.; Harlow, Susan A.; Glover, Andrea S.; Deane, Daniel A.; Guill, Margaret F.; Hudson, Valera L

doi:10.1007/s002470100456

Cited by 107 publications

(90 citation statements)

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“…It has also been suggested that cough is a less reliable indicator of aspiration in a younger age group, due to disruptions in postnatal maturation of airway clearance mechanisms or desensitisation secondary to repeated aspiration [11,27]. In particular, apnoea has been noted to be indicative of aspiration in infants, with cessation of respiration, closure of the airway and multiple swallows until clearance of the aspirated substance has occurred [11,28]. The current authors found that infants demonstrated stridor, apnoea/desaturations and wet breathing significantly more frequently during feeds than the older group, but none of these signs were significantly associated with OPA.…”

Section: Influence Of Age and Neurological Statusmentioning

confidence: 99%

Clinical signs and symptoms of oropharyngeal aspiration and dysphagia in children

Weir¹,

McMahon²,

Barry³

et al. 2008

Eur Respir J

115

111

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The diagnostic value of various signs and symptoms (clinical markers) in predicting oropharyngeal aspiration (OPA) or swallowing dysfunction has not been established in children. The present retrospective study was undertaken to: 1) identify specific clinical markers associated with radiographic evidence of OPA, isolated laryngeal penetration (ILP) and postswallow residue (PSR); 2) determine the sensitivity and specificity of clinical markers associated with OPA; and 3) determine the influence of age and neurological impairment on clinical markers of OPA.In total, 11 clinical markers of dysphagia were compared with the videofluoroscopic swallow study (VFSS) results (OPA, ILP and PSR) in 150 children on diets of thin fluid and purée consistencies. Chi-squared and logistic regression were used to analyse the association between clinical markers and VFSS-identified swallowing dysfunction.In children with OPA, wet voice (odds ratio (OR) 8.90, 95% confidence interval (CI) 2.87-27.62), wet breathing (OR 3.35, 95% CI 1.09-10.28) and cough (OR 3.30, 95% CI 1.17-9.27) were significantly associated with thin fluid OPA. Predictive values included: wet voice (sensitivity 0.67; specificity 0.92); wet breathing (sensitivity 0.33; specificity 0.83); and cough (sensitivity 0.67; specificity 0.53). No clinical markers were significantly associated with OPA, ILP or PSR on the purée consistency. Cough was significantly associated with PSR on thin fluids (OR 3.59, 95% CI 1.22-10.55). Differences were found for age.Wet voice, wet breathing and cough were good clinical markers for children with oropharyngeal aspiration on thin fluid but not on purée. Age and neurological status influenced the significance of these clinical markers.

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Section: Influence Of Age and Neurological Statusmentioning

confidence: 99%

Clinical signs and symptoms of oropharyngeal aspiration and dysphagia in children

Weir¹,

McMahon²,

Barry³

et al. 2008

Eur Respir J

115

111

View full text Add to dashboard Cite

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“…Videofluoroscopic swallow study (VFSS) is the gold-standard radiographic test for evaluating swallowing, 9 and VFSS abnormalities are common among infants clinically thought to have difficulty swallowing. [10][11][12][13] Which infant characteristics predict VFSS abnormalities and whether interventions designed to protect the airway are efficacious remain unclear. An observational study in infants with neurologic impairment did not find a decrease in respiratory admissions after fundoplication.…”

mentioning

confidence: 99%

Infant Videofluoroscopic Swallow Study Testing, Swallowing Interventions, and Future Acute Respiratory Illness

Coon¹,

Srivastava

Stoddard

et al. 2016

Hospital Pediatrics

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OBJECTIVES: Tube feedings are commonly prescribed to infants with swallowing abnormalities detected by videofluoroscopic swallow study (VFSS), but there are no studies demonstrating efficacy of these interventions to reduce risk of acute respiratory illness (ARI). We sought to measure the association between swallowing interventions and future ARI, among VFSS-tested infants. METHODS: Retrospective cohort of all infants (<12 months) tested with VFSS at a children’s hospital between January 1, 2010, and January 1, 2012. Hospital ARI encounters (emergency, observation, or inpatient status) in a 22-hospital integrated health care delivery system, between the first VFSS and age 3 years, were measured. VFSS results were grouped by normal, intermediate, and oropharyngeal aspiration (OPA), with OPA further subdivided by silent versus cough and thin versus thick liquid OPA. Cox regression modeled the association between swallowing interventions (thickened or nasal tube feedings) and ARI, accounting for changes in swallowing and interventions over time. RESULTS: 576 infants were tested with a VFSS in their first year of life, receiving a total of 1051 VFSSs in their first 3 years of life. More than 60% of infants received a measured feeding intervention. With the exception of infants with silent OPA who received thickened feedings, neither thickening nor nasal tube feedings, compared with no intervention, were associated with a decreased risk of subsequent ARI. CONCLUSIONS: Swallowing interventions and repeated testing are common among VFSS-tested infants. However, the importance of diagnosing and intervening on VFSS-detected swallowing abnormalities for the majority of tested infants remains unclear.

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“…Children with respiratory problems may present swallowing alterations, which can be observed in videofluoroscopic evaluation (22,(24)(25)(26) . According to some authors, swallowing disorders are frequently observed in infants with history of bronchitis and/or recurrent pneumonia.…”

Section: Introductionmentioning

confidence: 99%

“…Swallowing disorders with aspiration are a common cause of difficulties related to feeding in infancy (12) . Studies have showed that videofluoroscopy is a method able to detect aspiration, silent or not, and to appropriately identify the swallowing alterations, which allow therapeutic planning and the establishment of compensatory mechanisms (12,22,23) . Abnormal videofluoroscopy results in newborns include nasopharyngeal reflux, laryngeal penetration and aspiration, with a high incidence of silent aspiration.…”

Section: Introductionmentioning

confidence: 99%

Achados fluoroscópicos da deglutição: comparação entre recém-nascidos pré-termo e recém-nascidos de termo

Silva-Munhoz

Bühler

2011

J. Soc. Bras. Fonoaudiol.

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OBJETIVO: Descrever os achados fluoroscópicos da deglutição de recém-nascidos pré-termo de zero a seis meses de idade, assim como as doenças e os sinais e sintomas clínicos relacionados à alteração na deglutição, e compará-los com os respectivos dados obtidos de recém-nascidos de termo. MÉTODOS: Foram analisados, retrospectivamente, os dados das avaliações fluoroscópicas realizadas no período de um ano em lactentes de zero a seis meses de idade e aos respectivos prontuários. Participaram 40 sujeitos, divididos em dois grupos: Grupo Pré-Termo, constituído de 23 recém-nascidos pré-termo; e Grupo de Termo, constituído por 17 recém-nascidos de termo. RESULTADOS: Os principais achados fluoroscópicos da deglutição observados em ambos os grupos foram refluxo para a nasofaringe e refluxo gastresofágico. Não houve diferença entre os grupos para a presença de alteração na deglutição . O Grupo Pré-Termo apresentou mais problemas cardíacos do que o Grupo de Termo. Não houve diferença entre os grupos para problemas neurológicos e respiratórios. Em relação aos sinais e sintomas clínicos sugestivos de alteração na deglutição, o Grupo Pré-Termo apresentou mais dessaturação de oxigênio e o Grupo de Termo mais vômitos. CONCLUSÃO: Os principais achados fluoroscópicos da deglutição encontrados em recém-nascidos pré-termo de zero a seis meses de idade foram refluxo para a nasofaringe e refluxo gastresofágico. Novos estudos de seguimento desta população devem ser realizados para confirmar a hipótese de que as alterações na deglutição observadas ocorreram devido à imaturidade na função de deglutição.

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Swallowing dysfunction in infants less than 1 year of age

Cited by 107 publications

References 0 publications

Clinical signs and symptoms of oropharyngeal aspiration and dysphagia in children

Clinical signs and symptoms of oropharyngeal aspiration and dysphagia in children

Infant Videofluoroscopic Swallow Study Testing, Swallowing Interventions, and Future Acute Respiratory Illness

Achados fluoroscópicos da deglutição: comparação entre recém-nascidos pré-termo e recém-nascidos de termo

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