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Oropharyngeal aspiration and pneumonia in children

Weir, Kelly, McMahon, Sandra, Barry, Linda, Ware, Robert S., Masters, Ian B. and Chang, Anne B. (2007). Oropharyngeal aspiration and pneumonia in children. Pediatric Pulmonology,42(11):1024-1031.

Document type: Journal Article
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IRMA ID 10491xPUB106
Title Oropharyngeal aspiration and pneumonia in children
Author Weir, Kelly
McMahon, Sandra
Barry, Linda
Ware, Robert S.
Masters, Ian B.
Chang, Anne B.
Journal Name Pediatric Pulmonology
Publication Date 2007
Volume Number 42
Issue Number 11
ISSN 8755-6863   (check CDU catalogue  open catalogue search in new window)
Start Page 1024
End Page 1031
Total Pages 8
Place of Publication US
Publisher John Wiley & Sons, Inc.
Field of Research 1114 - Paediatrics and Reproductive Medicine
HERDC Category C1 - Journal Article (DEST)
Abstract Oropharyngeal aspiration (OPA) of food and fluids is known to be associated with pneumonia in dysphagic children with neurological disease and direct causality is often assumed. However, little is known about the relationship between OPA and pneumonia in medically complex children when other possible risk factors for pneumonia are considered. We examined the association of World Health Organization (WHO)-defined pneumonia in a heterogeneous group of children with swallowing dysfunction identified by a videofluoroscopic swallow study (VFSS). A retrospective chart review of 150 children (aged 2 weeks to 20 years) was undertaken to determine the relationship between pneumonia and (i) type of swallowing dysfunction (including OPA), (ii) consistency of aspirated food/fluid, and (iii) other factors including multisystem involvement and age (<= 1 year or >1 year). In univariate analysis, the odds ratio (OR) for pneumonia was significantly increased in children with post-swallow residue (PSR) (OR 2.5) or aspiration on thin fluids (OR 2.4), but not with aspiration of thick fluids or purees. In multi-logistic regression, type of swallowing dysfunction or aspirated food/fluid were no longer significant. Instead, pneumonia was significantly associated with diagnosis of asthma (OR 13.25), Down syndrome (OR 22.10), gastroesophageal reflux disease (GERD) (OR 4.28), or history of LRTI (OR 8.28), moist cough (OR 9.17) or oxygen supplementation (OR 6.19). Children with multisystem involvement demonstrated a higher association with pneumonia, but no difference was found for age. We conclude that the impact of OPA on development of pneumonia is considerably reduced once other factors in children with multisystem involvement Eire taken into account.
Keywords aspiration
oropharyngeal aspiration
dysphagia
modified barium swallow
pneumonia
videofluoroscopy
videofluoroscopic swallow study
DOI http://dx.doi.org/10.1002/ppul.20687   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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Created: Mon, 08 Sep 2008, 16:16:22 CST