Simultaneous Videofluoroscopy and Endoscopy for Dysphagia Evaluation in Preterm Infants—A Pilot Study

Kamity, Ranjith; Ferrara, Louisa; Dumpa, Vikramaditya; Reynolds, Jenny; Islam, Shahidul; Hanna, Nazeeh

doi:10.3389/fped.2020.00537

Cited by 14 publications

(19 citation statements)

References 29 publications

(42 reference statements)

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“…Further analysis of the samples showed that three studies included only infants from the neonatal intensive care unit (NICU) [ 12 , 14 , 18 ], one focused on mechanically ventilated children [ 23 ], and two had a surgical focus [ 13 , 25 ]. Six studies related to a single diagnosis or symptom: Congenital Zika Syndrome [ 22 ], isolated Pierre-Robin sequence [ 15 ], laryngomalacia [ 16 ] and gastroesophageal reflux disease (GERD) [ 17 ], cerebral palsy [ 26 ], and prematurity [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

Implementation of Pediatric Flexible-Endoscopic Evaluation of Swallowing: A Systematic Review and Recommendations for Future Research

et al. 2022

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Background Although pediatric flexible-endoscopic evaluation of swallowing (FEES) has developed into a standard in dysphagia diagnostics, there are no valid protocols and procedures for children available to date. Objective This systematic PROSPERO-registered review aimed to identify implementation protocols for pediatric FEES described in research studies, and to analyze them in detail concerning procedural steps, equipment, and reported outcome. Methods Included were all studies reporting a pediatric FEES protocol for children aged 0–18 years, if they described at least two criteria defined in advance. The databases MEDLINE and CINHAL were searched systematically from January 2000 to February 2021. Risk of bias for included studies was assessed using the National Institutes of Health (NIH) quality assessment tool for observational cohort and cross-sectional studies. A narrative synthesis of the FEES protocols was conducted and the results compared in tabular form. Results In total 22 studies were included, reporting on FEES in 1547 infants, children, and adolescents with a wide range of diagnoses. It was possible to identify protocols related to all age groups in general as well as to particular groups such as breastfed or bottle-fed infants. None of the included studies demonstrated a good methodological quality; all studies had missing data. Uniform implementation for sub-groups could not be determined. The reported outcome of FEES examinations could not be compared. Discussion None of the included studies showed good methodological quality and a significant amount of data were missing; the review still offers a systematic basis for future research to close the serious gap in the area of pediatric FEES. A proposal is made for a minimum requirement for pediatric FEES protocols in scientific studies.

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Section: Resultsmentioning

confidence: 99%

Implementation of Pediatric Flexible-Endoscopic Evaluation of Swallowing: A Systematic Review and Recommendations for Future Research

et al. 2022

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“…In preterm infants with dysphagia, simultaneous video-fluoroscopy and TFL in evaluation of swallowing has been proposed feasible and with higher diagnostic yield than each procedure done separately. 99 We believe that TFL performed during ongoing non-invasive respiratory therapies improve our understanding of laryngeal responses, and aids tailoring and individual optimizing of treatment ( Table 3)…”

Section: Where Should We Go From Here?mentioning

confidence: 99%

Upper Airway Assessment and Responses During Mechanically Assisted Cough

et al. 2021

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When ability to cough is impaired, secretion clearance may be assisted and augmented by Mechanical Insufflation-Exsufflation (MI-E). In some individuals, the efficacy of MI-E may be hampered by counterproductive upper airway reactions, where the airways close in response to positive pressures. In order to fully utilize the therapeutic potential inherent in the MI-E technology, we need a better understanding of the pathophysiology behind these untoward reactions. There is an increasing interest in monitoring and measuring upper airway responses to MI-E, and how such information can be used to optimize the MI-E settings. The purpose of this narrative review is to increase the theoretical understanding of larynx as a respiratory organ, summarize the current literature in the area, and provide insight into how this knowledge can affect current clinical practice.

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“…Both VFSS and FEES are complementary studies that can provide different perspectives. Studies comparing VFSS and FEES showed significant agreement between the two [ 75 , 76 ]. An upper gastrointestinal fluoroscopic (UGI) study can also identify anatomical abnormalities of the esophagus and upper small bowel, including malrotation, gastric outlet obstruction, abnormal esophageal clearance, hiatal hernia, and abnormal duodenal clearance.…”

Section: Addressing Oral Feeding Issues Earlymentioning

confidence: 99%

“…Conversely, fiberoptic evaluation of swallowing (FEES) provides a direct view of the airway during actual feeding, without the risk of ionizing radiation, but with a momentary white-out period at the pharyngo-esophageal transfer. Introduced in the 1980, FEES has only recently gained popularity in the neonatal population due to the development of smaller neonatal-sized endoscopes [72][73][74][75][76][77][78]. Both VFSS and FEES are complementary studies that can provide different perspectives.…”

Section: Instrumental Assessmentmentioning

confidence: 99%

Feeding Problems and Long-Term Outcomes in Preterm Infants—A Systematic Approach to Evaluation and Management

2021

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Preterm infants are known to have long-term healthcare needs. With advances in neonatal medical care, younger and more preterm infants are surviving, placing a subset of the general population at risk of long-term healthcare needs. Oral feeding problems in this population often play a substantial yet under-appreciated role. Oral feeding competency in preterm infants is deemed an essential requirement for hospital discharge. Despite achieving discharge readiness, feeding problems persist into childhood and can have a residual impact into adulthood. The early diagnosis and management of feeding problems are essential requisites to mitigate any potential long-term challenges in preterm-born adults. This review provides an overview of the physiology of swallowing and oral feeding skills, disruptions to oral feeding in preterm infants, the outcomes of preterm infants with feeding problems, and an algorithmic approach to the evaluation and management of neonatal feeding problems.

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Simultaneous Videofluoroscopy and Endoscopy for Dysphagia Evaluation in Preterm Infants—A Pilot Study

Cited by 14 publications

References 29 publications

Implementation of Pediatric Flexible-Endoscopic Evaluation of Swallowing: A Systematic Review and Recommendations for Future Research

Implementation of Pediatric Flexible-Endoscopic Evaluation of Swallowing: A Systematic Review and Recommendations for Future Research

Upper Airway Assessment and Responses During Mechanically Assisted Cough

Feeding Problems and Long-Term Outcomes in Preterm Infants—A Systematic Approach to Evaluation and Management

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