Dysphagia and associated clinical markers in neurologically intact children with respiratory disease

• Published in: Pediatric pulmonology 2018-04, Vol.53 (4), p.517-525
• Main Authors: Sassi, Fernanda C., Bühler, Karina C. B., Juste, Fabiola S., Almeida, Fabiola C. F., Befi‐Lopes, Debora M., de Andrade, Claudia R. F.
• Format: Article
• Language: English
• Subjects: Child, Preschool; Deglutition; deglutition disorders; Deglutition Disorders - etiology; Dysphagia; Female; Hospitalization; Humans; Infant; Intubation; Intubation, Intratracheal - adverse effects; Male; Patient admissions; pediatric; Respiratory diseases; respiratory impairment; Respiratory Tract Diseases - complications; Respiratory Tract Diseases - therapy; swallowing
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.23955

Objective The identification of oropharyngeal aspiration is paramount since it can have negative consequences on a compromised respiratory status. Our hypothesis was that dysphagia in neurologically intact children with respiratory disease is associated to specific clinical markers. Study Design Using the medical files we conducted a retrospective, observational cohort study on children admitted to the pediatric hospital unit due to respiratory disease. We collected data on specific parameters of a clinical swallowing assessment and dysphagia was classified according to the Dysphagia Management Staging Scale. We also included the following clinical markers: age, days of hospitalization, need for orotracheal intubation (OTI), duration of orotracheal intubation (in hours), number of previous hospital admissions due to respiratory disease, number of previous hospital admissions due to other causes, and previous orotracheal intubations. Results The final study sample consisted of 102 patients (mean age of 5.88 months). For the purposes of statistical analysis, the patients were grouped according to the classification of dysphagia (ie, no dysphagia, mild dysphagia, and moderate‐severe dysphagia). Data analysis indicated that the clinical markers of orotracheal intubation (P = 0.042), duration of orotracheal intubation (P = 0.025), and days of hospitalization (P = 0.037) were significant in children with moderate‐severe dysphagia. Conclusions Our data indicate that neurologically intact children with respiratory disease who were submitted to prolonged OTI (ie, over 48 h) should be prioritized for receiving a detailed swallowing assessment.