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Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration

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...

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Autores principales: Stafler, Patrick, Akel, Khaled, Eshel, Yuliana, Shimoni, Adi, Grozovski, Sylvia, Mei‐Zahav, Meir, Levine, Hagit, Gendler, Yulia, Blau, Hannah, Prais, Dario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325498/
https://www.ncbi.nlm.nih.gov/pubmed/35316543
http://dx.doi.org/10.1111/apa.16338
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author Stafler, Patrick
Akel, Khaled
Eshel, Yuliana
Shimoni, Adi
Grozovski, Sylvia
Mei‐Zahav, Meir
Levine, Hagit
Gendler, Yulia
Blau, Hannah
Prais, Dario
author_facet Stafler, Patrick
Akel, Khaled
Eshel, Yuliana
Shimoni, Adi
Grozovski, Sylvia
Mei‐Zahav, Meir
Levine, Hagit
Gendler, Yulia
Blau, Hannah
Prais, Dario
author_sort Stafler, Patrick
collection PubMed
description 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.
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spelling pubmed-93254982022-07-30 Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration Stafler, Patrick Akel, Khaled Eshel, Yuliana Shimoni, Adi Grozovski, Sylvia Mei‐Zahav, Meir Levine, Hagit Gendler, Yulia Blau, Hannah Prais, Dario Acta Paediatr Original Articles & Brief Reports 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. John Wiley and Sons Inc. 2022-04-06 2022-07 /pmc/articles/PMC9325498/ /pubmed/35316543 http://dx.doi.org/10.1111/apa.16338 Text en © 2022 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles & Brief Reports
Stafler, Patrick
Akel, Khaled
Eshel, Yuliana
Shimoni, Adi
Grozovski, Sylvia
Mei‐Zahav, Meir
Levine, Hagit
Gendler, Yulia
Blau, Hannah
Prais, Dario
Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration
title Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration
title_full Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration
title_fullStr Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration
title_full_unstemmed Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration
title_short Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration
title_sort videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration
topic Original Articles & Brief Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325498/
https://www.ncbi.nlm.nih.gov/pubmed/35316543
http://dx.doi.org/10.1111/apa.16338
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