Assessment of the Concerns of Caregivers of Children with Repaired Esophageal Atresia–Tracheoesophageal Fistula Related to Feeding–Swallowing Difficulties

Arslan, Selen Serel; Demir, Numan; Karaduman, Aynur Ayşe; Tanyel, Feridun Cahit; Soyer, Tutku

doi:10.1007/s00455-019-10046-5

“…The lower thoracic esophagus is located at the level of trachea bifurcation to the horizontal position of diaphragm. Based on the characteristics of type [24]. Here, our research proved that HC, AC, and EFW of EA fetuses were lower than those of normal fetuses, indirectly supporting this view.…”

Section: Discussionsupporting

confidence: 78%

“…EA gastric bubble collapse can cause fetal growth and dysplasia. It was reported that in middle and late pregnancy, protein intake of EA fetus is reduced by 2 g/d compared with normal fetus [ 24 ]. Here, our research proved that HC, AC, and EFW of EA fetuses were lower than those of normal fetuses, indirectly supporting this view.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Prenatal Ultrasound Parameters and Esophageal Signs in Pouch and Lower Thoracic Segment in Fetuses with Esophageal Atresia

Feng

¹

2021

Computational and Mathematical Methods in Medicine

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In order to investigate the diagnostic value of prenatal ultrasound parameters and signs of pouch and lower thoracic esophagus in the fetus with esophageal atresia (EA), the prenatal ultrasound data of 35 EA fetuses (observation group) confirmed by autopsy after induced labor or postnatal surgery and imaging examination in our hospital from May 2019 to May 2021 were retrospectively analyzed and compared with 35 normal postnatal fetuses (control group). General information and prenatal ultrasound parameters of the two groups, including head circumference (HC), abdominal circumference (AC), double parietal diameter (BPD), fetal body weight (EFW), and signs (small or unmanifested gastric vesicles, amniotic fluid, neck or upper chest pouch, lower chest esophagus not visible), were analyzed using logistic regression. The logistic multifactor regression model for EA diagnosis was established, and the diagnostic value for EA was analyzed. As a result, the HC, AC, and EFW of the observation group were lower than those of the control group, the gastric bubbles were small or not displayed, the amniotic fluid was more, and the signs of neck or upper chest pouch and lower chest esophagus were not visible in the observation group ( P < 0.05 ). Logistic regression analysis showed that decreased ultrasound parameters HC, AC, EFW, small or no gastric bubble, amniotic fluid, neck or upper chest pouch, and no visible signs of lower chest esophagus were all risk factors for EA ( P < 0.05 ). And in the prenatal ultrasound diagnostic model of EA was established, logistic P = − 19.851 + HC × 0.384 + AC × 0.682 + EFW × 0.695 + small or no gastric vesicle × 3.747 + amniotic fluid × 3.607 + cervical or upper chest sac × 4.104 + invisible lower thoracic esophagus × 4.623 .When logistic P > 0.468 , AUC was 0.891, χ 2 was 7.764, diagnostic sensitivity was 91.24%, and specificity was 79.22%. To draw a conclusion, prenatal ultrasound parameters and signs are of great value in the diagnosis of EA. Independent influencing factors of EA include small or no HC, AC, EFW and gastric vesicles, polyhydramnios, neck or upper chest pouch, and invisible lower thoracic esophagus. Logistic multifactor regression model has a high coincidence rate for the prenatal diagnosis of EA, providing a basis for clinical decision-making.

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“…The study demonstrated that more than 95% of all children could be weaned successfully and needed no tube feeds after completion of the tube weaning program, with three children requiring partial tube feeds. Previous studies have shown that many children with EA, especially those with long-gap EA, suffer from feeding difficulties [7,8,22] and that some of these children are discharged on home ENS [8]. Many children with EA succeed in the transition to oral nutrition on their own; however, a large proportion-especially among those with comorbidities [8]-does not succeed in transitioning to oral intake despite implementation of various supportive measures.…”

Section: Discussionmentioning

confidence: 99%

“…A gastrostomy is often placed in the first days of life [1], particularly in cases of long-gap EA. As a result, some patients may miss the chance to acquire a natural swallowing mechanism [6][7][8]. Furthermore, motility problems are quite frequent in children with esophageal atresia [6].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a standardized tube weaning program in pediatric patients with feeding difficulties after successful repair of their esophageal atresia/tracheoesophageal fistula

Marinschek

¹

,

Pahsini

²

,

Aguiriano-Moser

³

et al. 2020

Eur J Pediatr

2

0

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Children born with esophageal atresia (EA) might suffer from significant oral feeding problems which could evolve into tube dependency. The primary aim of the study was to define the outcome of tube weaning in children after successful EA repair and to compare outcomes in children with short gap/TEF (tracheoesophageal fistula) and long-gap EA. Data of 64 children (28 with short-gap EA/TEF with primary anastomosis and 36 with long-gap EA with delayed surgical repair) who participated in a standardized tube weaning program based on the “Graz model of tube weaning” (in/outpatients in an intensive 3-week program, online coaching (Netcoaching) only, or a combined 2-week intensive onsite followed by online treatment “Eating School”) from 2009 to 2019 was evaluated. Sixty-one patients completed the program by transitioning to exclusive oral intake (95.3%). Three children (4.7%) were left partially weaned at the time of discharge. No significant differences could be found between short gap/TEF and long-gap EA group regarding outcomes. Conclusions: The study’s findings support the efficacy of tube weaning based on the published “Graz model of tube weaning” for children born with EA/TEF and indicate the necessity of specialized tube weaning programs for these patients. What is Known:• Children with esophageal atresia/tracheoesophageal fistula often suffer from feeding problems and tube dependency.• Different tube weaning programs and outcomes have been published, but not specifically for children with EA. What is New:• Evaluation of a large sample of children referred for tube weaning after EA repair.• Most children with EA can be weaned off their feeding tubes successfully after attending a specialized tube weaning program.

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“…FS-IS is the first validated instrument designed to measure the impact of children's feeding/swallowing problems their caregivers [18]. To date, it has been validated as a quality of life (QOL) instrument for caregivers of children with cerebral palsy [18,19], laryngeal clefts [20], eosinophilic esophagitis [21], and esophageal atresia and tracheoesophageal fistula [22]. In addition, it has been translated from English into Turkish and validated for children with cerebral palsy [19].…”

Section: Introductionmentioning

confidence: 99%

Translation, Cultural Adaptation, Reliability, and Validity Evidence of the Feeding/Swallowing Impact Survey (FS–IS) to Brazilian Portuguese

Rama

¹

,

Bernardes

²

,

Lefton‐Greif

³

et al. 2021

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The purpose of this study was to translate and adapt the Feeding/Swallowing Impact Survey (FS-IS) into Brazilian Portuguese and provide a validated instrument for caregivers of children with feeding/swallowing disorders. This cross-cultural study involved initial translation, synthesis of translations, back-translation, Committee of Experts, and pre-test. The sample consisted of 95 primary caregivers of children with feeding/swallowing disorders classified by Pediatric Dysphagia Evaluation Protocol (PDEP) in mild (n = 9), moderate-severe (n = 40), or profound (n = 46) dysphagia. Reliability and evidence of validity based on test content, response processes, internal structure and the relations to other variables were investigated. Internal consistency, test-retest, exploratory and confirmatory factor analysis were performed, in addition to the correlation with PedsQL™ Family Impact Module (PedsQL TM FIM). The pre-test participants did not report any difficulties in understanding the translated version. The Brazilian Portuguese version of FS-IS (Pt-Br-FS-IS) presented Cronbach's Alpha of 0.83, Exploratory Factor Analysis verified that the instrument would not be unifactorial (KMO = 0.74 and Bartlett's sphericity test p < 0.001) and Confirmatory Factor Analysis confirmed the original model in three subscales with χ 2 /df = 1.23, CFI = 0.92, TLI = 0.90, RMSEA (90% CI) 0.049 (0.011-0.073) adjustment indexes and the ICC was excellent in all subscales and total score. The correlation with PedsQL™FIM was significant in the total score and subscales. This study successfully translated and cross-culturally adapted the FS-IS instrument to the Brazilian Portuguese language and the investigation of its reliability and validity evidence suggests that the Pt-Br-FS-IS is a reliable and valid tool to measure the impact of feeding/swallowing disorders on the quality of life of caregivers of affected children.

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Assessment of the Concerns of Caregivers of Children with Repaired Esophageal Atresia–Tracheoesophageal Fistula Related to Feeding–Swallowing Difficulties

Cited by 9 publications

References 27 publications

Diagnostic Value of Prenatal Ultrasound Parameters and Esophageal Signs in Pouch and Lower Thoracic Segment in Fetuses with Esophageal Atresia

Diagnostic Value of Prenatal Ultrasound Parameters and Esophageal Signs in Pouch and Lower Thoracic Segment in Fetuses with Esophageal Atresia

Efficacy of a standardized tube weaning program in pediatric patients with feeding difficulties after successful repair of their esophageal atresia/tracheoesophageal fistula

Translation, Cultural Adaptation, Reliability, and Validity Evidence of the Feeding/Swallowing Impact Survey (FS–IS) to Brazilian Portuguese

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