Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration

Area of Science:

• Pediatric gastroenterology
• Pulmonology
• Diagnostic imaging

Background:

• Videofluoroscopy swallow studies (VFSS) are the gold standard for diagnosing aspiration in children but involve radiation and resource use.
• Clinical feeding evaluation (CFE) is a less resource-intensive alternative, but its diagnostic and management impact requires further evaluation.

Purpose of the Study:

• To evaluate the added diagnostic value of VFSS compared to CFE in children.
• To assess the impact of VFSS on feeding management and clinical status in pediatric patients.
• To determine if VFSS can lead to improved clinical outcomes and reduced healthcare utilization.

Main Methods:

• A retrospective, single-center, cross-sectional study was conducted.
• 113 children aged 0-18 years with respiratory morbidity, referred for VFSS, were included.
• Data on diagnoses, aspiration status, feeding methods, and clinical outcomes were analyzed.

Main Results:

• VFSS identified aspiration in 41% of children, including silent aspirations.
• Children with chronic pulmonary aspiration (CPA) or cerebral palsy were more likely to aspirate.
• VFSS led to significant changes in feeding recommendations, increasing the rate of oral feeding and decreasing reliance on enteral feeding.
• There was a significant reduction in antibiotic courses and hospital admissions in the year following VFSS.

Conclusions:

• VFSS significantly altered feeding management in children with suspected CPA when compared to CFE.
• The findings suggest that VFSS may contribute to improved clinical status and reduced respiratory morbidity in this pediatric population.