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. 2022 Jul;111(7):1441-1449.
doi: 10.1111/apa.16338. Epub 2022 Apr 6.

Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration

Patrick Stafler  1   2 , Khaled Akel  1 , Yuliana Eshel  3 , Adi Shimoni  3 , Sylvia Grozovski  2   4 , Meir Mei-Zahav  1   2 , Hagit Levine  1   2 , Yulia Gendler  5 , Hannah Blau  1   2 , Dario Prais  1   2
Affiliations

Videofluoroscopy compared with clinical feeding evaluation in children with suspected aspiration

Patrick Stafler et al. Acta Paediatr. 2022 Jul.

Abstract

Aim: Videofluoroscopy swallow studies (VFSS) are gold standard to diagnose aspiration in children but require resources and radiation compared with clinical feeding evaluation (CFE). We evaluated their added value for diagnosis, feeding management and clinical status.

Methods: A retrospective single-centre cross-sectional study of children aged 0-18 years, with respiratory morbidity, referred for VFSS at a tertiary pediatric hospital.

Results: A total of 113 children, median age (range) 2.2 years (0.1-17.9), underwent VFSS. Diagnosis included chronic pulmonary aspiration (CPA), 87 (77%); neurological, 73 (64%); gastrointestinal, 73 (64%) and congenital heart disease, 42 (37%), not mutually exclusive. Forty-six (41%) aspirated, 9 (8%) only overtly and 37 (33%) including silent aspirations. Those with CPA or cerebral palsy were more likely to have VFSS aspiration, OR 3.2 and 9.8 respectively. Feeding recommendations after VFSS differed significantly from those based on prior CFE, p < 0.001: The rate of exclusively orally fed children rose from 65% to 79%, p = 0.006; exclusively enterally fed children from 10% to 14%; p = 0.005. During the year after VFSS, there were significantly less antibiotic courses, total and respiratory admissions.

Conclusion: In this population with high prevalence of clinically suspected CPA, VFSS altered feeding management compared with CFE and may have contributed to subsequent clinical improvement.

Keywords: chronic pulmonary aspiration; overt aspiration; silent aspiration; videofluoroscopic swallow study.

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Conflict of interest statement

None of the authors has any conflict of interest to declare.

Figures

FIGURE 1
FIGURE 1
Purpose‐built adaptable chair, adjustable in a way that mimics the child's usual feeding position
FIGURE 2
FIGURE 2
Flow diagram of examined patient population including results of clinical feeding evaluation and video‐fluoroscopic swallow studies
FIGURE 3
FIGURE 3
Aspiration status—no aspirations, overt or silent aspirations—according to food texture trialled, as identified on videofluoroscopy swallow study. N = 113
See this image and copyright information in PMC

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