TY - JOUR
T1 - Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration
AU - Stafler, Patrick
AU - Akel, Khaled
AU - Eshel, Yuliana
AU - Shimoni, Adi
AU - Grozovski, Sylvia
AU - Mei-Zahav, Meir
AU - Levine, Hagit
AU - Gendler, Yulia
AU - Prais, Dario
N1 - Publisher Copyright: © 2022 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.
PY - 2022/7
Y1 - 2022/7
N2 - Aim: Videofluoroscopy swallow studies (VFSS) are gold standard to diagnose aspiration in children but require resources and radiation compared with clinical feeding evaluation (CFE). We evaluated their added value for diagnosis, feeding management and clinical status. Methods: A retrospective single-centre cross-sectional study of children aged 0–18 years, with respiratory morbidity, referred for VFSS at a tertiary pediatric hospital. Results: A total of 113 children, median age (range) 2.2 years (0.1–17.9), underwent VFSS. Diagnosis included chronic pulmonary aspiration (CPA), 87 (77%); neurological, 73 (64%); gastrointestinal, 73 (64%) and congenital heart disease, 42 (37%), not mutually exclusive. Forty-six (41%) aspirated, 9 (8%) only overtly and 37 (33%) including silent aspirations. Those with CPA or cerebral palsy were more likely to have VFSS aspiration, OR 3.2 and 9.8 respectively. Feeding recommendations after VFSS differed significantly from those based on prior CFE, p < 0.001: The rate of exclusively orally fed children rose from 65% to 79%, p = 0.006; exclusively enterally fed children from 10% to 14%; p = 0.005. During the year after VFSS, there were significantly less antibiotic courses, total and respiratory admissions. Conclusion: In this population with high prevalence of clinically suspected CPA, VFSS altered feeding management compared with CFE and may have contributed to subsequent clinical improvement.
AB - Aim: Videofluoroscopy swallow studies (VFSS) are gold standard to diagnose aspiration in children but require resources and radiation compared with clinical feeding evaluation (CFE). We evaluated their added value for diagnosis, feeding management and clinical status. Methods: A retrospective single-centre cross-sectional study of children aged 0–18 years, with respiratory morbidity, referred for VFSS at a tertiary pediatric hospital. Results: A total of 113 children, median age (range) 2.2 years (0.1–17.9), underwent VFSS. Diagnosis included chronic pulmonary aspiration (CPA), 87 (77%); neurological, 73 (64%); gastrointestinal, 73 (64%) and congenital heart disease, 42 (37%), not mutually exclusive. Forty-six (41%) aspirated, 9 (8%) only overtly and 37 (33%) including silent aspirations. Those with CPA or cerebral palsy were more likely to have VFSS aspiration, OR 3.2 and 9.8 respectively. Feeding recommendations after VFSS differed significantly from those based on prior CFE, p < 0.001: The rate of exclusively orally fed children rose from 65% to 79%, p = 0.006; exclusively enterally fed children from 10% to 14%; p = 0.005. During the year after VFSS, there were significantly less antibiotic courses, total and respiratory admissions. Conclusion: In this population with high prevalence of clinically suspected CPA, VFSS altered feeding management compared with CFE and may have contributed to subsequent clinical improvement.
KW - chronic pulmonary aspiration
KW - overt aspiration
KW - silent aspiration
KW - videofluoroscopic swallow study
UR - http://www.scopus.com/inward/record.url?scp=85127669914&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/apa.16338
DO - https://doi.org/10.1111/apa.16338
M3 - مقالة
C2 - 35316543
SN - 0803-5253
VL - 111
SP - 1441
EP - 1449
JO - Acta Paediatrica, International Journal of Paediatrics
JF - Acta Paediatrica, International Journal of Paediatrics
IS - 7
ER -