L Ferrara1, A Bidiwala2, I Sher3, M Pirzada4, D Barlev3, S Islam5, W Rosenfeld6, C C Crowley7, N Hanna8. 1. Division of Pediatric Gastroenterology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA. 2. Division of Respiratory and Sleep Medicine, Children's Hospital at Montefiore, Bronx, NY, USA. 3. Department of Radiology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA. 4. Division of Pediatric Pulmonology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA. 5. Department of Biostatistics, Winthrop University Hospital, Mineola, NY, USA. 6. Department of Pediatrics, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA. 7. Hearing and Speech Center, Long Island Jewish Medical Center, New Hyde Park, NY, USA. 8. Division of Neonatology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
Abstract
OBJECTIVE: Feeding neonates orally while on nasal continuous positive airway pressure (nCPAP) is a common practice. We hypothesize that pressurized airflow provided by nCPAP will alter the swallowing mechanism in neonates, increasing the risk of aspiration during oral feeding. STUDY DESIGN: Infants receiving nCPAP with a RAM cannula and tolerating at least 50% of their feeding orally were included in the study (one term; six preterm infants). Each participant underwent a videofluoroscopic swallow study while on nCPAP and off nCPAP. A non-parametric signed-rank test was used for paired data. RESULT: The incidence of deep penetration (P=0.03) and aspiration (P=0.01) decreased significantly off-nCPAP compared with on-nCPAP. However, the incidence of mild penetration (P=0.65) and nasopharyngeal reflux (P=0.87) remained the same under both conditions. CONCLUSION: Oral feeding while on-nCPAP significantly increases the risk of laryngeal penetration and tracheal aspiration events. We recommend caution when initiating oral feedings on nCPAP.
OBJECTIVE: Feeding neonates orally while on nasal continuous positive airway pressure (nCPAP) is a common practice. We hypothesize that pressurized airflow provided by nCPAP will alter the swallowing mechanism in neonates, increasing the risk of aspiration during oral feeding. STUDY DESIGN:Infants receiving nCPAP with a RAM cannula and tolerating at least 50% of their feeding orally were included in the study (one term; six preterm infants). Each participant underwent a videofluoroscopic swallow study while on nCPAP and off nCPAP. A non-parametric signed-rank test was used for paired data. RESULT: The incidence of deep penetration (P=0.03) and aspiration (P=0.01) decreased significantly off-nCPAP compared with on-nCPAP. However, the incidence of mild penetration (P=0.65) and nasopharyngeal reflux (P=0.87) remained the same under both conditions. CONCLUSION: Oral feeding while on-nCPAP significantly increases the risk of laryngeal penetration and tracheal aspiration events. We recommend caution when initiating oral feedings on nCPAP.
Authors: Jane E Brumbaugh; Tarah T Colaizy; Shampa Saha; Krisa P Van Meurs; Abhik Das; Michele C Walsh; Edward F Bell Journal: Early Hum Dev Date: 2018-04-11 Impact factor: 2.079