Clinical outcomes before and after videofluoroscopic swallowing study in
children up to 24 months old.
Abstract
Purpose: To compare clinical outcomes associated with pediatric
oropharyngeal dysphagia, before and after videofluoroscopic swallow
study (VFSS) and feeding strategies recommendations. Methods: A
longitudinal, analytical uncontrolled study with evaluation before and
after VFSS was performed. Children between 0 and 24 months were included
in the study. Each participant received recommendations for the
therapeutic management of oropharyngeal dysphagia after the VFSS, as
well as follow-up care at a hospital Outpatient Clinic for Pediatric
Dysphagia in order to monitor feeding and swallowing complaints. The
respiratory and feeding outcomes were compared. Results: A
penetration/aspiration event was observed in 61% of the
videfluoroscopic exams (n=72). Feeding strategies to improve
biomechanical coordination and swallowing safety were required for 97%
of the examined children. After the exam, there was a reduction in the
use and length of antibiotic therapy (p=0.036), in the number of
children who had been admitted to hospital (p<0.001), in the
frequency (p=0.037), and in the length of hospitalization (p=0.025).
There was an increase in combined oral and enteral feeding in relation
to isolated feeding routes (p=0.002). Conclusions: This study data shows
a high prevalence of penetration / aspiration in VFSS in this
population. The therapeutic management of oropharyngeal dysphagia,
guided by objective examinations, was associated with a decrease in
respiratory morbidity in children included.