VIDEOFLUOROSCOPY OF PRETERM INFANT SWALLOWING

早产儿吞咽的视频荧光检查

• 批准号: 7045996
• 负责人: EUGENE C GOLDFIELD
• 金额: $ 31.83万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7045996
• 关键词: behavioral /social science research tag; biomechanics; clinical research; dysphagia; esophagus motility /pressure; fluoroscopy; gastrointestinal imaging /visualization; human subject; muscle strength; oral behavior; patient oriented research; physiology; premature infant human; sensorimotor system; statistics /biometry; swallowing; tongue; video recording system

DESCRIPTION (provided by applicant): The survival of preterm infants born less than 33 weeks gestational age (GA) has increased dramatically over the past decade, but these infants are likely to exhibit impaired swallowing, or dysphagia, when they begin oral feeding. Half will continue to exhibit dysphagia after 36 weeks, when full volume oral feedings should be achieved without difficulty. Dysphagia has significant clinical consequences, including malnutrition growth retardation, and risk of pneumonia associated with taking fluid into the airway. Dysphagia among preterm infants is more pronounced when swallowing thin fluids. Due to their CNS immaturity, preterm infants may have greater difficulty detecting the flow properties of thin fluids. Subjects are dysphagic preterm infants, born less than 33 weeks GA, initially referred by physician between 36 to 42 weeks to Children's Hospital for a VFSS evaluation. The specific aims are to test 3 hypotheses concerning swallowing and airway protection as preterm infants swallow thin or thick fluids during videofluoroscopic swallow study. Two hypotheses are tested at a 36 to 42 week VFSS: (1) aspiration of fluid will be more likely to occur during swallows in which there is poor coordination between a swallow gesture (e.g., the tongue base sealing the airway) and fluid bolus movement, (2) Timing of swallow movements will be less well coordinated with fluid bolus transit when swallowing thin fluids compared to thick fluids. The third hypothesis is tested at a followup three month VFSS for infants who exhibited fluid aspiration during the 36 to 42 week evaluation, and who were prescribed a thickened formula for home feedings: (3) At three months, compared to the initial VFSS, there will be improved coordination between swallow movements and bolus transit and no fluid aspiration. The study hypotheses are tested by experimental manipulation of barium sulfate viscosity during infant swallowing, kinematic analysis of recorded swallow images, and non-radiologic recordings of sucking, swallowing, and breathing during a regular feeding after the VFSS evaluation is completed.

描述（由申请人提供）：在过去十年中，胎龄 (GA) 不足 33 周的早产儿的存活率显着增加，但这些婴儿在开始经口喂养时可能会表现出吞咽障碍或吞咽困难。一半的人在 36 周后会继续表现出吞咽困难，此时应该可以毫无困难地实现全量口服喂养。吞咽困难具有显着的临床后果，包括营养不良、生长迟缓以及与将液体吸入气道相关的肺炎风险。早产儿吞咽稀薄液体时的吞咽困难更为明显。由于中枢神经系统不成熟，早产儿可能更难以检测稀薄液体的流动特性。受试者是 GA 出生不到 33 周的吞咽困难早产儿，最初在 36 至 42 周期间由医生转诊至儿童医院进行 VFSS 评估。具体目的是测试早产儿在电视透视吞咽研究中吞咽稀薄或粘稠液体时有关吞咽和气道保护的 3 个假设。在 36 至 42 周的 VFSS 中测试了两个假设：(1) 在吞咽过程中，如果吞咽姿势（例如，舌根密封气道）和液体推注运动之间协调性较差，则更有可能发生液体误吸。 (2) 与稠液体相比，吞咽稀液体时，吞咽运动的时间与液体推注运输的协调性较差。第三个假设是在后续三个月的 VFSS 中对在 36 至 42 周评估期间表现出液体吸入并且被开出浓稠配方奶粉用于家庭喂养的婴儿进行测试：(3) 与最初的 VFSS 相比，三个月时，有将改善吞咽运动和丸剂运输之间的协调性，并且不会吸入液体。该研究假设通过婴儿吞咽过程中硫酸钡粘度的实验操作、记录的吞咽图像的运动学分析以及 VFSS 评估完成后定期喂养期间吸吮、吞咽和呼吸的非放射记录进行了测试。