VIDEOFLUOROSCOPY OF PRETERM INFANT SWALLOWING

早产儿吞咽的视频荧光检查

• 批准号: 6852174
• 负责人: EUGENE C GOLDFIELD
• 金额: $ 32.33万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6852174
• 关键词: behavioral /social science research tag; biomechanics; clinical research; dysphagia; esophagus motility /pressure; fluoroscopy; gastrointestinal imaging /visualization; human subject; muscle strength; oral behavior; patient oriented research; physiology; premature infant human; sensorimotor system; statistics /biometry; swallowing; tongue; video recording system

DESCRIPTION (provided by applicant): The survival of preterm infants born less than 33 weeks gestational age (GA) has increased dramatically over the past decade, but these infants are likely to exhibit impaired swallowing, or dysphagia, when they begin oral feeding. Half will continue to exhibit dysphagia after 36 weeks, when full volume oral feedings should be achieved without difficulty. Dysphagia has significant clinical consequences, including malnutrition growth retardation, and risk of pneumonia associated with taking fluid into the airway. Dysphagia among preterm infants is more pronounced when swallowing thin fluids. Due to their CNS immaturity, preterm infants may have greater difficulty detecting the flow properties of thin fluids. Subjects are dysphagic preterm infants, born less than 33 weeks GA, initially referred by physician between 36 to 42 weeks to Children's Hospital for a VFSS evaluation. The specific aims are to test 3 hypotheses concerning swallowing and airway protection as preterm infants swallow thin or thick fluids during videofluoroscopic swallow study. Two hypotheses are tested at a 36 to 42 week VFSS: (1) aspiration of fluid will be more likely to occur during swallows in which there is poor coordination between a swallow gesture (e.g., the tongue base sealing the airway) and fluid bolus movement, (2) Timing of swallow movements will be less well coordinated with fluid bolus transit when swallowing thin fluids compared to thick fluids. The third hypothesis is tested at a followup three month VFSS for infants who exhibited fluid aspiration during the 36 to 42 week evaluation, and who were prescribed a thickened formula for home feedings: (3) At three months, compared to the initial VFSS, there will be improved coordination between swallow movements and bolus transit and no fluid aspiration. The study hypotheses are tested by experimental manipulation of barium sulfate viscosity during infant swallowing, kinematic analysis of recorded swallow images, and non-radiologic recordings of sucking, swallowing, and breathing during a regular feeding after the VFSS evaluation is completed.

描述（由申请人提供）：在过去十年中，胎龄（GA）小于33周的早产儿的存活率显著增加，但这些婴儿在开始经口喂养时可能表现出吞咽受损或吞咽困难。一半将在36周后继续表现出吞咽困难，此时应无困难地实现全量经口喂养。吞咽困难具有显著的临床后果，包括营养不良、生长迟缓和与将液体带入气道相关的肺炎风险。早产儿吞咽困难在吞咽稀薄液体时更为明显。由于他们的中枢神经系统的不成熟，早产儿可能有更大的困难，检测流动性质的稀薄液体。受试者是吞咽困难的早产儿，出生不到33周GA，最初由医生在36至42周之间转诊到儿童医院进行VFSS评估。具体目的是检验关于早产儿在视频透视吞咽研究期间吞咽稀或稠液体时吞咽和气道保护的3个假设。在36至42周VFSS时测试两个假设：（1）流体的吸入将更可能发生在吞咽期间，其中吞咽姿势（例如，密封气道的舌根）和流体团运动，（2）与粘稠流体相比，当吞咽稀薄流体时，吞咽运动的定时将与流体团传输不太协调。第三个假设在36 - 42周评估期间表现出液体吸入的婴儿的随访三个月VFSS中进行测试，并且这些婴儿被处方用于家庭喂养的增稠配方：（3）在三个月时，与初始VFSS相比，吞咽运动和食团输送之间的协调性将得到改善，并且没有液体吸入。通过婴儿吞咽期间硫酸钡粘度的实验操作、记录的吞咽图像的运动学分析以及VFSS评估完成后定期喂养期间吮吸、吞咽和呼吸的非放射性记录来测试研究假设。