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23
Aspiration pneumonia occurrence after completion of a videofluoroscopy
swallow study in high-risk children
Hellen Nataly Correia Lagos; Rosane Sampaio Santos; Adriane Celli; Edna Marcia
Silva Abdulmassih; Carlos Alberto do Amaral Medeiros
University Tuiuti of Paraná
Curitiba - Paraná - Brazil
Introduction: the literature reports that in the instrumental evaluation of the
swallowing mechanism in children, the videofluoroscopy swallow study offers,
beyond doubt, many advantages over the endoscopic study. In addition to being
technically more achievable, it practically recreates the actual swallowing
mechanism, but there are no reports in the literature of the risk of aspiration
potentiating the occurrence of aspiration pneumonia during the exam (MELLOFILHO, et al, 2009). Objective: therefore, the objective of this study was to verify the
occurrence of aspiration pneumonia after completion of a videofluoroscopy swallow
study in high-risk children. Method: 16 children, between the ages of 6 months and
10 years, participated in the study. They were referred by the paediatrics sector, with
complaints of dysphagia, for the completion of a videofluoroscopy swallow study.
Before carrying out the exams the children were submitted to chest x-rays to rule out
the possibility of previous pneumonia. Follow up exams were completed after one
week for medical evaluations and speech and language clinical evaluations and the
patients were referred for a chest x-ray to confirm any suspicions of pneumonia. This
study was approved by the Ethics Committee for Research, under number
000025/2009, of the Tuiuti University of Paraná. For a classification of the degree of
dysphagia, the Classification of Severity of Dysphagia by Videofluoroscopy of OTT et
al., (1996) was used, in which the classes were: Normal, Light Dysphagia, Moderate
Dysphagia and Serious Dysphagia. Results: of the respiratory symptoms before the
exam, 2 patients displayed coughing with catarrh and breathing difficulties, 1
displayed fever and dry coughing and 1 displayed coughing with catarrh only. And
regarding the patients who only displayed respiratory symptoms after completion of
the exam, only 1 patient had aspirated material from the exam but with no positive
diagnosis for pneumonia. Regarding the degree of dysphagia, there were 5 Normal
children, 4 displayed Light Dysphagia, 2 presented Moderate Dysphagia and 5
presented Serious Dysphagia. While carrying out the exam, 7 patients displayed
aspiration of a liquid consistency, and of these, 2 patients also displayed aspiration of
a solid consistency, 4 displayed aspiration of both a pasty and a fine consistency and
the remaining 5 displayed no aspiration. Conclusion: in the present study it can be
concluded that among the population studied there was no occurrence of aspiration
pneumonia after completion of the exams.
Keywords: Swallowing affliction; Fluoroscopy; Aspiration pneumonia