A Retrospective Examination of Prandial Aspiration in Preterm Infants Purpose We conducted this retrospective study to identify potential signs of aspiration in preterm infants based on crib-side nursing documentation. Study Design and Methods A total of 2,590 bottle-feedings were examined for signs of distress across 41 preterm infants who were referred for a swallowing evaluation. All infants ... Article
Article  |   October 01, 2015
A Retrospective Examination of Prandial Aspiration in Preterm Infants
Author Affiliations & Notes
  • Neina F. Ferguson
    Audiology and Speech Language Pathology, East Tennessee State University, Johnson City, TN
  • Julie Estis
    Speech Pathology and Audiology, University of South Alabama, Mobile, AL
  • Kelli Evans
    Department of Speech-Pathology and Audiology, Western Washington University, Bellingham, WA
  • Paul A. Dagenais
    Department of Speech-Pathology and Audiology, University of South Alabama, Mobile, AL
  • James VanHangehan
    Department of Education, University of South Alabama, Mobile, AL
  • Financial Disclosure: Neina F. Ferguson is an assistant professor at East Tennessee State University. Julie Estis is director of the Quality Enhancement Plan and associate professor of speech-language pathology at the University of South Alabama. Kelli Evans is an assistant professor at Western Washington University. Paul A. Dagenais is a professor at the University of South Alabama. James VanHangehan is a professor at the University of South Alabama.
    Financial Disclosure: Neina F. Ferguson is an assistant professor at East Tennessee State University. Julie Estis is director of the Quality Enhancement Plan and associate professor of speech-language pathology at the University of South Alabama. Kelli Evans is an assistant professor at Western Washington University. Paul A. Dagenais is a professor at the University of South Alabama. James VanHangehan is a professor at the University of South Alabama.×
  • Nonfinancial Disclosure: Neina F. Ferguson, Julie Estis, Kelli Evans, Paul A. Dagenais, and James VanHangehan have no nonfinancial interests related to the content of this article.
    Nonfinancial Disclosure: Neina F. Ferguson, Julie Estis, Kelli Evans, Paul A. Dagenais, and James VanHangehan have no nonfinancial interests related to the content of this article.×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Articles
Article   |   October 01, 2015
A Retrospective Examination of Prandial Aspiration in Preterm Infants
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), October 2015, Vol. 24, 162-174. doi:10.1044/sasd24.4.162
History: Received March 21, 2015 , Revised June 21, 2015 , Accepted June 21, 2015
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), October 2015, Vol. 24, 162-174. doi:10.1044/sasd24.4.162
History: Received March 21, 2015; Revised June 21, 2015; Accepted June 21, 2015

Purpose We conducted this retrospective study to identify potential signs of aspiration in preterm infants based on crib-side nursing documentation.

Study Design and Methods A total of 2,590 bottle-feedings were examined for signs of distress across 41 preterm infants who were referred for a swallowing evaluation. All infants underwent either a videofluoroscopic swallow study (VSS) or upper gastrointestinal study (GIS). Physiologic and behavioral warning signs were coded across feedings 10 days prior to the imaging study. Presence or absence of documented aspiration during VSS/GIS was coded for each infant.

Results Distress signs were documented in seven percent of oral feeding attempts. Aspiration was more common when the crib-side nurse documented coughing (LR+, 8.77; 95% CI, .99–77.09), compromised oxygen saturation levels (LR+, 2.15; CI, .86–5.47), and tachypnea (LR+, 2.15; CI, .28–3.01) during bottle-feeding.

Clinical Implications Evidence-based distress signs that signal increased suspicion for prandial aspiration will facilitate correct clinical judgments at crib-side. Early identification and prevention of prandial aspiration improves health outcomes for preterm infants.

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