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Published on: March 1, 2015
Feeding and Swallowing Outcomes in Children Who Use Long-Term Ventilation: A Scoping Review
Sabrena Lee1,2, Jeanne Marshall3,4, Michael Clarke5
1Evelina London Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.
Insights
Children requiring long-term ventilation (LTV) often face feeding and swallowing challenges. This review highlights common issues and the prevalence of non-oral feeding in this pediatric population.
Area of Science:
- Pediatric Medicine
- Respiratory Care
- Swallowing Disorders
Background:
- Long-term ventilation (LTV) use in children has increased over the past two decades.
- Children on LTV often have comorbidities and medical histories that increase risks for feeding and swallowing difficulties.
Purpose of the Study:
- To identify specific feeding and swallowing characteristics in children using LTV.
- To determine the impact of these characteristics on health status and quality of life.
Main Methods:
- A comprehensive literature search was conducted across multiple databases and grey literature.
- 31 studies were included after screening 1919 papers, analyzing data on ventilation, feeding/swallowing, interventions, and quality of life.
Main Results:
- Common issues include oral secretion management problems, oral aversion, dysphagia, and clinical signs of aspiration.
- Non-oral feeding is the predominant method used by children requiring LTV.
- Limited data was found regarding the impact on health status and quality of life.
Conclusions:
- Children on LTV exhibit diverse feeding and swallowing concerns, with non-oral feeding being common.
- Further research is essential to understand their feeding and swallowing experiences.
- Improved understanding will aid service planning and enhance patient outcomes and quality of life.
Abstract:
The last two decades have seen increasing use of long-term ventilation (LTV) as an intervention in childhood. Children who use LTV have many risk factors for feeding and swallowing difficulties, including their underlying respiratory and/or neurological etiology, long hospitalizations, medical interventions, and limited exposure to oral feeding experiences. This review aimed to answer two questions: 1) 'What specific swallowing and feeding characteristics do these children experience?'; and 2) 'What impacts do these swallowing and feeding characteristics have on health status and quality of life?'. Texts were identified across bibliographic databases, reference lists, and grey literature. Studies were analyzed according to ventilation, feeding and swallowing, assessment and intervention, and quality of life parameters. Overall, 1919 papers were screened, with 31 papers included in the final data extraction process. A range of feeding and swallowing characteristics were observed, including oral secretion management difficulties, oral aversion, swallowing difficulties, and clinical signs of aspiration. Non-oral feeding was found to be the primary feeding method used. Little information on health status and quality of life was reported in scoping review texts. Children with LTV needs present with a range of feeding and swallowing concerns, and non-oral feeding is common. Further research is needed to understand the feeding and swallowing journey of this population. This will assist in future service planning and delivery, and in turn contribute to improving patient outcomes and quality of life.
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