Voice and Swallowing Dysfunction Associated With Extracorporeal Membrane Oxygenation in Pediatric Patients

Area of Science:

• Pediatric critical care medicine
• Otolaryngology
• Speech-language pathology

Background:

• Cervical extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for critically ill neonates and children.
• Potential complications include vocal fold motion impairment (VFMI) and swallowing dysfunction, impacting long-term outcomes.
• Limited data exists on the incidence and interplay of these dysfunctions following pediatric cervical ECMO.

Purpose of the Study:

• To determine the incidence of VFMI and swallowing dysfunction in pediatric patients undergoing cervical ECMO.
• To investigate the role of screening in identifying these complications.
• To highlight the clinical significance of vocal and swallowing issues in this population.

Main Methods:

• Retrospective cohort analysis of pediatric patients (2012-2019) who underwent cervical ECMO.
• Data collection included patient demographics, ECMO details, intubation duration, and feeding interventions.
• Voice, swallowing, and airway evaluations were reviewed.

Main Results:

• 77 pediatric patients were included; 23% had VFMI and 26% had swallowing dysfunction.
• 15.6% experienced concurrent VFMI and swallowing dysfunction post-decannulation.
• Lower weight at cannulation was associated with VFMI; screening was underutilized despite concerns.

Conclusions:

• VFMI and swallowing dysfunction are prevalent complications in pediatric cervical ECMO survivors.
• This study underscores a significant risk, potentially underestimating true incidence.
• Prospective evaluation is needed for prompt identification and intervention.