Upper GI examinations in older premature infants with persistent apnea: correlation with simultaneous cardiorespiratory monitoring

Itani, Yasushi; Fujioka, Masashi; Nishimura, Go; Niitsu, Naoki; Oono, Tsutomu

doi:10.1007/bf00974080

Cited by 10 publications

(5 citation statements)

References 27 publications

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“…[29] It is associated not only with apnea, but also with choking and history of pneumonia in infants. [30][31][32] Although none of the 7 infants with nasopharyngeal refl ux in our study showed laryngeal penetration or aspiration, the potential for aspiration might be underestimated.…”

Section: Discussionmentioning

confidence: 69%

Swallowing dysfunction in very low birth weight infants with oral feeding desaturation

et al. 2011

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Section: Discussionmentioning

confidence: 69%

Swallowing dysfunction in very low birth weight infants with oral feeding desaturation

et al. 2011

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“…6 Nasopharyngeal reflux has been associated with apnea, choking, and a history of pneumonia in the infant. [7][8][9] Preterm infants who were nursed in the head-elevated tilt position, altering swallowing function, were found to have significantly fewer brady-cardic or hypoxemic episodes when compared with a horizontal position. 10 Despite the strength of the relationship between dysphagia and respiratory complications, there is little understanding of the biomechanics of infant dysphagia.…”

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confidence: 99%

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confidence: 99%

Swallowing Function and Medical Diagnoses in Infants Suspected of Dysphagia

et al. 2001

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ABSTRACT.Objective. There has been an increase in infant swallowing disorders as a result of improved survival for infants born prematurely or with life-threatening medical disorders. These infants often have multiple health issues and an increased risk of respiratory complications. However, there is little understanding of the biomechanics of infant swallowing disorders. Therefore, the objectives of this study were to determine 1) the percentage of dysphagic infants who experience laryngeal penetration, aspiration, or nasopharyngeal backflow; 2) reasons for laryngeal penetration/aspiration; 3) whether infants with laryngeal penetration/aspiration clear their airway; and 4) the relationship between swallowing disorders and medical diagnoses.Methods. Patients included 43 infants who were referred for videofluoroscopic swallowing studies in a university-affiliated pediatric medical center. Medical charts were reviewed. The videofluroscopic swallowing studies were recorded on videotape, and each swallow was analyzed for laryngeal penetration, aspiration, nasopharyngeal backflow, cough, airway clearance, and reason for penetration/aspiration. Statistics included 2 for nonparametric data and measures of central tendency for numeric/timing data.Results. More than half of the infants experienced laryngeal penetration, aspiration, or nasopharyngeal backflow; however, the first occurrence of these events was after multiple swallows. Only 3 infants experienced laryngeal penetration and aspiration on the first swallow and all 3 had an absent pharyngeal response. Premature infants experienced significantly more nasopharyngeal backflow. Material in the pyriform sinuses before pharyngeal swallowing was associated with penetration/aspiration. In episodes of laryngeal penetration, all patients were able to clear their airway during the swallow without a cough. Almost all infants (8 of 9) who aspirated did not cough or clear their airway.Conclusions. This study demonstrated that most infants suspected of dysphagia showed overt abnormalities: laryngeal penetration, aspiration, and/or nasopharyngeal backflow on the videofluoroscopic swallowing study. Most of these infants did not demonstrate abnormalities in the first few swallows but displayed deterioration in swallowing function as they continued to feed. Thus, radiographic assessments in infants must examine multiple swallows. The high incidence of silent aspiration demonstrates the necessity of a videofluoroscopic assessment to evaluate swallowing function in these infants. Pediatrics 2001;108(6). URL: http://www. pediatrics.org/cgi/content/full/108/6/e106; aspiration, dysphagia, laryngeal penetration, prematurity, pneumonia.ABBREVIATIONS. MBS, modified barium swallow; SD, standard deviation.T here has been an increase in infant swallowing disorders as a result of improved survival rates for infants born prematurely or with lifethreatening medical disorders. These infants often have multiple health issues and an increased risk of respiratory complications. Disorders of sucking...

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“…5 With videofluoroscopy, it has been demonstrated that apnea and bradycardia occurred during retention of barium in the hypopharynx and/or nasopharyngeal backflow. [6][7][8] Therefore, any premature or term infant who has difficulty feeding and/or has experienced apnea, bradycardia, cyanosis, or a near-miss sudden infant death syndrome episode should be evaluated for dysphagia.…”

Section: Identifying Infants and Children With Dysphagiamentioning

confidence: 99%

Optimal Care Patterns in Pediatric Patients with Dysphagia

Newman¹

2000

Semin Speech Lang

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The pediatric population with dysphagia is diverse, ranging from premature infants to fully grown adolescents. A variety of medical conditions cause swallowing disorders in pediatric patients. Complications of swallowing disorders can have severe and even fatal consequences. Swallowing disorders have a direct impact on nutrition, and adequate nutrition is required for growth and development of all body systems in infants and children. Infants and children may not have the same symptoms and signs as adults with dysphagia do and learning to identify pediatric patients at risk for dysphagia is critical. The diagnosis must be thorough and accurate. Furthermore, management of swallowing disorders and nutrition must be aggressive and immediate because of the reduced nutritional reserve and high needs of the infant and child. This article discusses the following three areas for optimal care: identification of infants and children at risk for dysphagia, diagnostic procedures, and management.

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Upper GI examinations in older premature infants with persistent apnea: correlation with simultaneous cardiorespiratory monitoring

Cited by 10 publications

References 27 publications

Swallowing dysfunction in very low birth weight infants with oral feeding desaturation

Swallowing dysfunction in very low birth weight infants with oral feeding desaturation

Swallowing Function and Medical Diagnoses in Infants Suspected of Dysphagia

Optimal Care Patterns in Pediatric Patients with Dysphagia

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