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Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
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Dysphagia testing and aspiration status in medically stable infants requiring mechanical ventilation via tracheotomy

Steven B Leder1, Kenneth E Baker, T Rob Goodman

  • 1Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, CT, USA. Steven.Leder@Yale.edu

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 4, 2010
PubMed

Insights

Objective dysphagia testing in mechanically ventilated infants via tracheotomy is safe and effective. Most infants showed no aspiration, allowing for timely oral feeding initiation.

Area of Science:

  • Pediatric Gastroenterology
  • Neonatology
  • Speech-Language Pathology

Background:

  • Infants requiring mechanical ventilation via tracheotomy are often considered at high risk for aspiration and feeding difficulties.
  • Limited data exists on diagnostic testing for aspiration and interventions to facilitate oral feeding in these medically stable infants.

Purpose of the Study:

  • To conduct objective testing to assess aspiration status in medically stable, ventilator-dependent infants.
  • To determine the safety and efficacy of initiating oral alimentation in this population.

Main Methods:

  • Prospective study of 14 ventilator-dependent infants (mean age 8.1 months) referred for swallow evaluation.
  • Utilized videofluoroscopic and fiberoptic endoscopic evaluations of swallowing (FEES).

Main Results:

  • Objective testing identified aspiration status in all infants.
  • Despite some exhibiting oral dysphagia, 13 of 14 (93%) infants demonstrated safe pharyngeal swallowing without aspiration.
  • Successful initiation of oral diets was achieved in 93% of the infants.

Conclusions:

  • Objective dysphagia testing is recommended for ventilator-dependent infants with tracheotomy.
  • The prevalence of aspiration in this cohort is low, and negative findings support safe and timely oral feeding.
  • This approach can facilitate earlier oral alimentation and improve patient outcomes.
Abstract

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