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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
04:32

Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia

Published on: June 28, 2018

Oropharyngeal aspiration and pneumonia in children

Kelly Weir1, Sandra McMahon, Linda Barry

  • 1Department of Paediatrics and Child Health, University of Queensland, Herston, Queensland, Australia. k.weir1@uq.edu.au

Pediatric Pulmonology
|September 26, 2007
PubMed

Insights

Oropharyngeal aspiration (OPA) is less linked to pneumonia in medically complex children than previously thought. Other factors like asthma and GERD are stronger predictors of pneumonia in these children.

Area of Science:

  • Pediatric Medicine
  • Pulmonology
  • Gastroenterology

Background:

  • Oropharyngeal aspiration (OPA) is often presumed to cause pneumonia in children with neurological and swallowing issues.
  • However, the direct link between OPA and pneumonia in medically complex children, considering other risk factors, is not well understood.

Purpose of the Study:

  • To investigate the association between World Health Organization (WHO)-defined pneumonia and oropharyngeal aspiration (OPA) in children with swallowing dysfunction.
  • To identify other contributing factors to pneumonia in this population, including type of swallowing dysfunction, aspirated food/fluid consistency, and patient characteristics.

Main Methods:

  • Retrospective chart review of 150 children (2 weeks to 20 years) with swallowing dysfunction identified via videofluoroscopic swallow study (VFSS).
  • Analysis of the relationship between pneumonia and swallowing dysfunction (including OPA), aspirated material consistency, multisystem involvement, and age.

Main Results:

  • Univariate analysis showed increased odds of pneumonia with post-swallow residue (PSR) and aspiration of thin fluids, but not thick fluids or purees.
  • Multivariable analysis revealed pneumonia was significantly associated with asthma, Down syndrome, gastroesophageal reflux disease (GERD), history of lower respiratory tract infection (LRTI), moist cough, and oxygen supplementation.
  • Swallowing dysfunction and aspirated material consistency were not significant predictors in the multivariable model.

Conclusions:

  • The direct impact of oropharyngeal aspiration (OPA) on pneumonia development is significantly reduced when other risk factors are considered in medically complex children.
  • Conditions such as asthma, Down syndrome, GERD, and prior respiratory infections are stronger predictors of pneumonia in this group.

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