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Oropharyngeal aspiration in pediatric patients with endotracheal intubation

Sérgio L Amantéa1, Jefferson P Piva, Paulo R S Sanches

  • 1Pediatric Emergency Room, Hospital da Criança Santo Antônio, Complexo Santa Casa, Porto Alegre, RS, Brazil.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|February 28, 2004
PubMed

Insights

Oropharyngeal aspiration affects 28% of pediatric patients on mechanical ventilation. Frequent swallowing and orotracheal intubation increase aspiration risk, suggesting nasotracheal intubation may be preferable.

Area of Science:

  • Pediatric critical care medicine
  • Respiratory physiology
  • Clinical research methodology

Background:

  • Oropharyngeal aspiration is a potential complication in pediatric patients requiring mechanical ventilation and endotracheal intubation.
  • Identifying factors associated with aspiration is crucial for patient safety and optimizing ventilation strategies.

Purpose of the Study:

  • To determine the prevalence of oropharyngeal aspiration in pediatric patients undergoing mechanical ventilation.
  • To identify factors associated with oropharyngeal aspiration, including sedation level, swallowing dynamics, and intubation route.

Main Methods:

  • Prospective cross-sectional study conducted in four pediatric intensive care units.
  • Fifty infants and children on mechanical ventilation were assessed for aspiration using Evans blue dye.
  • Swallowing frequency was monitored via surface electromyography; data analyzed using chi-square, relative risk, and multivariate analysis.

Main Results:

  • The overall prevalence of aspiration was 28%.
  • Aspiration was significantly associated with inadequate sedation, frequent swallowing movements, and the orotracheal intubation route.
  • Multivariate analysis confirmed independent associations between aspiration and frequent swallowing movements and the orotracheal route.

Conclusions:

  • Oropharyngeal aspiration is a common complication in mechanically ventilated children.
  • Frequent swallowing and orotracheal intubation are significant risk factors for aspiration.
  • Nasotracheal intubation may be a preferred route to mitigate this clinical complication.
Abstract

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