Oropharyngeal aspiration and pneumonia in children

Weir, Kelly, McMahon, Sandra, Barry, Linda, Ware, Robert, Masters, I. Brent and Chang, Anne B. (2007) Oropharyngeal aspiration and pneumonia in children. Pediatric Pulmonology, 42 11: 1024-1031. doi:10.1002/ppul.20687


Author Weir, Kelly
McMahon, Sandra
Barry, Linda
Ware, Robert
Masters, I. Brent
Chang, Anne B.
Title Oropharyngeal aspiration and pneumonia in children
Journal name Pediatric Pulmonology   Check publisher's open access policy
ISSN 8755-6863
1099-0496
Publication date 2007-11
Sub-type Article (original research)
DOI 10.1002/ppul.20687
Volume 42
Issue 11
Start page 1024
End page 1031
Total pages 8
Editor V. Chernick
Place of publication Hoboken, U.S.
Publisher John Wiley & Sons
Collection year 2008
Language eng
Subject 321019 Paediatrics
C1
730204 Child health
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.
Keyword Pediatrics
Respiratory System
aspiration
oropharyngeal aspiration
dysphagia
modified barium swallow
pneumonia
videofluoroscopy
videofluoroscopic swallow study
Feeding Disorders
Risk-factors
Respiratory Illness
Dysphagia
Childhood
Recurrent
Reflux
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2008 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Mon, 18 Feb 2008, 15:47:34 EST