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Using fiberoptic endoscopic evaluation of swallowing to detect laryngeal penetration and aspiration in infants in the neonatal intensive care unit

Journal of Perinatology volume 37, pages 404–408 (2017)Cite this article

Subjects

Abstract

Objective:

To evaluate the safety of fiberoptic endoscopic evaluation of swallowing (FEES) and the reliability of both FEES and a videofluoroscopic swallowing study (VFSS) in identifying laryngeal penetration and tracheal aspiration in infants under 3 months old in the neonatal intensive care unit (NICU).

Study Design:

Twenty-five infants at least 37 weeks postmenstrual age suspected of aspirating were assessed with FEES and VFSS. Complications, autonomic instability and vital signs before endoscope insertion and following FEES were documented. Blinded video recordings were coded by two reviewers to determine reliability.

Results:

We found no major complications or significant differences between FEES prefeeding and postfeeding vital signs, including respiratory rate, heart rate or oxygen saturation. FEES interrater reliability was 80% for both penetration and aspiration, compared with 87 and 90%, respectively, for VFSS.

Conclusion:

FEES is safe and reliable in assessing laryngeal penetration and tracheal aspiration in NICU infants.

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Acknowledgements

We are grateful to Monica Bennett, Gabriella Cantu, Elisa Priest, Simon Driver, Mary DeHaas, Rachel King, Misty Kyle, Jennifer Hendrikse, Lisa Tiltges and the Baylor Health Care System Foundation for their contributions to the study. Source of financial support/funding: Baylor Health Care System Foundation. ClinicalTrials.gov ID: NCT02003287.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Baylor University Medical Center, Dallas, TX, USA

    M S Suterwala

  2. Department of Physical Medicine, Baylor University Medical Center, Dallas, TX, USA

    J Reynolds, S Carroll & C Sturdivant

  3. Department of Communication Sciences and Disorders, Texas Woman’s University, Denton, TX, USA

    E S Armstrong

Authors
  1. M S Suterwala
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  2. J Reynolds
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  3. S Carroll
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  4. C Sturdivant
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  5. E S Armstrong
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Correspondence to M S Suterwala.

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The authors declare no conflict of interest.

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Suterwala, M., Reynolds, J., Carroll, S. et al. Using fiberoptic endoscopic evaluation of swallowing to detect laryngeal penetration and aspiration in infants in the neonatal intensive care unit. J Perinatol 37, 404–408 (2017). https://doi.org/10.1038/jp.2016.239

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