Document Detail


Swallowing dysfunction in infants less than 1 year of age.
MedLine Citation:
PMID:  11436889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Gastroesophageal reflux (GER) occurs frequently in infants and children and is implicated as a trigger for reactive airways disease. While evaluating patients for GER by upper gastrointestinal studies (UGI), we frequently noticed laryngeal penetration or tracheal aspiration in infants < 1 year of age. We conducted this prospective study to assess the incidence of swallowing dysfunction in infants with vomiting or respiratory symptoms. METHODS: Between February 1994 and August 1997, 1,003 UGI in infants < 1 year of age were performed by two experienced pediatric radiologists. Fluoroscopy of swallowing using an appropriate image intensifier was observed as part of the UGI in all patients. In addition to evaluating premature infants, former premature infants, and infants with underlying conditions such as bronchopulmonary dysplasia (BPD), congenital heart disease (CHD), esophageal atresia and/or tracheoesophageal fistula (EA), and neurologic disorders, we assessed swallowing in 472 full-term infants in the general population who had respiratory symptoms or suspected GER, but no other apparent abnormalities. Swallowing was not assessed in patients with congenital bowel obstruction. The presence of normal swallowing or swallowing dysfunction was recorded immediately following the study. Chest radiographs obtained on the same day as the UGI were evaluated in the study. Forty-four videotaped modified barium-swallow studies (MBSS) were obtained in 25 general-population infants and reviewed frame-by-frame to determine the length of time that barium could be visualized in the subglottic trachea. RESULTS: The incidence of swallowing dysfunction is significant in premature and former premature infants, those with BPD, CHD, EA, various syndromes, and neurologic abnormality. In the general population of full-term infants referred for evaluation of vomiting or respiratory symptoms, 63 (13.4 % of 472) had swallowing dysfunction. Forty-four had tracheal aspiration (TA) and 19 had laryngeal penetration (LP). Gastroesophageal reflux was found in 79.5 % with TA and in 68.4 % with LP. The MBSS confirmed swallowing dysfunction in all patients shown to have vocal cord penetration or tracheal aspiration by UGI. CONCLUSIONS: Careful evaluation of swallowing during an UGI can identify swallowing dysfunction in full-term infants who have respiratory problems, as well as in infants with an abnormality that predisposes the patient to aspiration. Episodes of tracheal aspiration may be fleeting and overlooked if swallowing is not assessed carefully. An MBSS can confirm the observation of swallowing dysfunction found during an UGI and assist in planning appropriate dietary therapy that minimizes the likelihood of tracheal aspiration during feeding.
Authors:
M G Mercado-Deane; E M Burton; S A Harlow; A S Glover; D A Deane; M F Guill; V Hudson
Related Documents :
8986999 - Recurrent apparent life-threatening event relieved by glossopexy.
12423479 - Fetal duodenal obstructions: increased risk of prenatal sudden death.
3735019 - Intestinal abnormalities with central nervous system malignancy.
7967749 - Mothers' internal working models with infants with gastroesophageal reflux.
24021919 - Inner ear insult ablates the arousal response to hypoxia and hypercarbia.
17204949 - Morphometric histology for infant gastroesophageal reflux disease: evaluation of reliab...
23208479 - Pattern of perinatal mortality in babies delivered at the university of ilorin teaching...
17444979 - Perception of object shape and texture in human newborns: evidence from cross-modal tra...
18322919 - Senescence of reproduction may explain adaptive menopause in humans: a test of the "mot...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric radiology     Volume:  31     ISSN:  0301-0449     ISO Abbreviation:  Pediatr Radiol     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-07-04     Completed Date:  2002-06-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0365332     Medline TA:  Pediatr Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  423-8     Citation Subset:  IM    
Affiliation:
Department of Radiology, Medical College of Georgia, Augusta, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Deglutition Disorders* / epidemiology
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Technique and clinical applications of full-inflation and end-exhalation controlled-ventilation ches...
Next Document:  Magnetic resonance imaging of the fetus in congenital intrathoracic disorders: preliminary observati...