Evaluating the Clinical Symptoms of Neonates with Suspected Dysphagia
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective To evaluate the prevalence of dysphagia in neonates who showed abnormal findings on videofluoroscopic swallowing studies (VFSSs), and to compare the accuracy of the clinical evaluation with the VFSS results. Method A clinical investigation of 142 neonates admitted to a neonatal intensive care unit was carried out to evaluate the presence of low O2 saturation (＜80%), symptoms of cyanosis, coughing and/or vomiting, nasal regurgitation, drooling saliva, voice change and crying during feeding. VFSSs were performed on the neonates who had at least one of these clinical abnormalities. Results Of the 142 patients, 37 (26.1%) had at least one of the clinical symptoms of dysphagia. Twenty two of 37 (59.5%) showed abnormal findings on the VFSS. The patients exhibiting cyanosis and coughing during feeding had a higher incidence of aspiration (11 of 11, 100%) on the VFSSs than did the patients with other symptoms: cyanosis (3 of 13, 30.8%), cyanosis with vomiting (0 of 2, 0.0%), coughing without cyanosis (2 of 5, 40.0%), voice change (2 of 2, 100%) and nasal regurgitation (1 of 3, 33.3%). Conclusion The prevalence of laryngeal penetration or subglottic aspiration among those neonates who were clinically suspected of dysphagia was 59.5%. Coughing with cyanosis during feeding was the best predictor of both these abnormalities.
Abstract
Objective To evaluate the prevalence of dysphagia in neonates who showed abnormal findings on videofluoroscopic swallowing studies (VFSSs), and to compare the accuracy of the clinical evaluation with the VFSS results. Method A clinical investigation of 142 neonates admitted to a neonatal intensive care unit was carried out to evaluate the presence of low O2 saturation (＜80%), symptoms of cyanosis, coughing and/or vomiting, nasal regurgitation, drooling saliva, voice change and crying during feeding. VFSSs were performed on the neonates who had at least one of these clinical abnormalities. Results Of the 142 patients, 37 (26.1%) had at least one of the clinical symptoms of dysphagia. Twenty two of 37 (59.5%) showed abnormal findings on the VFSS. The patients exhibiting cyanosis and coughing during feeding had a higher incidence of aspiration (11 of 11, 100%) on the VFSSs than did the patients with other symptoms: cyanosis (3 of 13, 30.8%), cyanosis with vomiting (0 of 2, 0.0%), coughing without cyanosis (2 of 5, 40.0%), voice change (2 of 2, 100%) and nasal regurgitation (1 of 3, 33.3%). Conclusion The prevalence of laryngeal penetration or subglottic aspiration among those neonates who were clinically suspected of dysphagia was 59.5%. Coughing with cyanosis during feeding was the best predictor of both these abnormalities.
참고문헌 (26)
- Lau C, "Coordination of suck-swallow and swallow respiration in preterm infants", Acta Paediatr, 92, pp.721~727 (2003)
- Gewolb IH, "Developmental patterns of rhythmic suck and swallow in preterm infants", Dev Med Child Neurol, 43, pp.22~27 (2001)
- Newman LA, "Swallowing function and medical diagnoses in infants suspected of dysphagia", Pediatrics, 108, pp.E106~E120 (2001)
- Kim HS, "Characteristics of swallowing disorder in pediatric patients with central nervous system disorders: comparing to central nervous system intact patients with gastro-intestinal disorders", J Korea Acad Rehab Med, 22, pp.506~515 (1998)
- Pritchard JA, "Fetal swallowing and amniotic fluid volume", Obstet Gynecol, 28, pp.606~610 (1966)
- Lau C, "Oral motor function in the neonate", Clin Perinatol, 23, pp.161~178 (1996)
- Mathew OP, "Science of bottle feeding", J Pediatr, 119, pp.511~519 (1991)
- Bauer MA, "The oral motor capacity and feeding performance of preterm newborns at the time of transition to oral feeding", Braz J Med Biol Res, 41, pp.904~907 (2008)
- Bu’Lock F, "Development of co-ordination of sucking, swallowing and breathing: ultrasound study of term and preterm infants", Dev Med Child Neurol, 32, pp.669~678 (1990)
- McCain GC, "An evidence-based guideline for introducing oral feeding to healthy preterm infants", Neonatal Netw, 22, pp.45~50 (2003)
- Amaizu N, "Maturation of oral feeding skills in preterm infants", Acta Paediatr, 97, pp.61~67 (2008)
- Kramer SS, "Special swallowing problems in children", Gastrointest Radiol, 10, pp.241~250 (1985)
- Newman LA, "Videofluoroscopic analysis of the infant swallow", Invest Radiol, 26, pp.870~873 (1991)
- Mendelson Y, "Pulse oximetry: theory and applications for noninvasive monitoring", Clin Chem, 38, pp.1601~1607 (1992)
- Rogers BT, "Hypoxemia during oral feeding of children with severe cerebral palsy", Dev Med Child Neurol, 35, pp.3~10 (1993)
- Logemann JA, "A Manual for the videofluorographic study of swallowing", pp.157~162 (1993), PRO-ED
- Rosenbeck JC, "A penetration-aspiration scale", Dysphagia, 11, pp.93~98 (1996)
- Wright RER, "Videofluoroscopic assessment in children with severe cerebral palsy presenting with dysphagia", Pediatr Radiol, 26, pp.720~722 (1996)
- Logemann JA, "A screening procedure for oropharyngeal dysphagia", Dysphagia, 14, pp.44~51 (1999)
- Smith CH, "Incidence and patient characteristics associated with silent aspiration in the acute care setting", Dysphagia, 14, pp.1~7 (1999)
- Splaingard ML, "Aspiration in rehabilitation patients: videofluoroscopy vs bedside clinical assessment", Arch Phys Med Rehabil, 69, pp.637~640 (1988)
- DeMatteo C, "Comparison of clinical and videofluoroscopic evaluation of children with feeding and swallowing difficulties", Dev Med Child Neurol, 47, pp.149~157 (2005)
- Arvedson J, "Silent aspiration prominent in children with dysphagia", Int J Pediatr Otorhinolaryngol, 28, pp.173~181 (1994)
- Linden P, "The probability of correctly predicting subglottic penetration from clinical observations", Dysphagia, 8, pp.170~179 (1993)
- Ott DJ, "Modified barium swallow: clinical and radiographic correlation and relation to feeding recommendations", Dysphagia, 11, pp.187~190 (1996)
- Leder SB, "Fiberoptic endoscopic evaluation of dysphagia to identify silent aspiration", Dysphagia, 13, pp.19~21 (1998)