VIDEOFLUOROSCOPY OF PRETERM INFANT SWALLOWING

早产儿吞咽的视频荧光检查

• 批准号: 7195775
• 负责人: EUGENE C GOLDFIELD
• 金额: $ 31.14万
• 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 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7195775
• 关键词: Address; Air; Aspirate substance; Barium; Barium Sulfate; Bolus Infusion; Breathing; Bronchial Tree; Chronic; Clinical; Deglutition; Deglutition Disorders; Esophagus; Evaluation; Evaluation Studies; Exhibits; Feeds; Food; Gestational Age; Gestures; Growth; Home environment; Human Milk; Image; Infant; Liquid substance; Malnutrition; Measures; Movement; Nasal cavity; Nature; Oral; Pathway interactions; Pediatric Hospitals; Pharyngeal structure; Physicians; Pneumonia; Premature Infant; Property; Regulation; Relative (related person); Respiration; Rice; Risk; Sensory; Survival Rate; Testing; Thick; Time; Tongue; Viscosity; Week; experience; feeding; fluid flow; follow-up; improved; kinematics; respiratory; seal; sucking; tongue root

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，小于33周胎龄（GA）出生的早产儿的存活率急剧增加，但这些婴儿在开始口服喂养时可能表现出吞咽受损或吞咽困难。一半的婴儿在36周后仍会出现吞咽困难，此时应该可以毫无困难地实现全量口服喂养。吞咽困难具有显著的临床后果，包括营养不良、生长迟缓以及因将液体吸入气道而发生肺炎的风险。早产儿吞咽困难在吞咽稀液体时更为明显。由于他们的中枢神经系统不成熟，早产儿可能有更大的困难检测薄流体的流动特性。研究对象是出生年龄小于33周的吞咽困难早产儿，最初由医生在36至42周之间转介到儿童医院进行VFSS评估。本研究的具体目的是检验3个关于吞咽和气道保护的假设，因为早产儿在透视下吞咽研究中吞咽了稀薄或粘稠的液体。在36至42周的VFSS中测试了两种假设：(1)吞咽时，吞咽姿势（例如，舌根密封气道）与液体丸运动之间的协调性较差，吞咽时更有可能发生液体的吸入；(2)吞咽稀液体时，吞咽运动的时间与液体丸运动的协调性较差。第三个假设在随访的3个月的VFSS中进行了测试，这些婴儿在36至42周的评估中表现出液体吸入性，并被规定了增稠的配方用于家庭喂养：(3)在3个月时，与最初的VFSS相比，吞咽运动和丸剂运输之间的协调性将得到改善，没有液体吸入性。通过对婴儿吞咽过程中硫酸钡粘度的实验操作，对吞咽图像记录的运动学分析，以及在VFSS评估完成后常规喂养过程中吸吮、吞咽和呼吸的非放射记录，对研究假设进行了验证。