J Korean Dysphagia Soc.  2023 Jan;13(1):48-53. 10.34160/jkds.2023.13.1.006.

Aspiration Pneumonia in Preterm Infants on Oral Feeds after Aspiration is Confirmed by VFSS: Case Series

• Lee KW
• Kim SB
• Kang MG
• Lee JH
• Ha WW

• KMID: 2539465
• DOI: http://doi.org/10.34160/jkds.2023.13.1.006

Abstract

Premature infants often face oral feeding problems. The videofluoroscopic swallow study (VFSS) is a commonly used method to detect subglottic aspiration. However, there is no consensus to date regarding the association of aspiration observed on VFSS and incidence of aspiration pneumonia in preterm infants. This study investigated the occurrence of aspiration pneumonia in preterm infants on oral feeds after aspiration has been confirmed by VFSS. This study included 50 preterm infants who had undergone VFSS. Among them, 13 patients with no aspiration, two patients who were lost to follow-up, and nine patients with massive aspiration were excluded from the analysis. In VFSS, the frequency and amount of aspiration, nasal penetration, suck-swallow ratio, and sucking power were assessed. We analyzed 26 patients with aspiration confirmed on VFSS but who had initiated oral feeding. The frequency of aspiration (percentage of the number of aspirations to the total number of swallowing) was 10.22±3.62 (%). The mean amount of aspiration was 2.28±1.02 (%). One preterm infant, born with very low-birthweight developed aspiration pneumonia 10 days after the initiation of full oral feeding. He was diagnosed with respiratory distress syndrome and had weak sucking power. In the absence of massive aspiration, most infants with aspiration confirmed on VFSS tolerated oral feeding, especially when oral feeding was partially initiated.

Keyword

Pneumonia; Aspiration; Bottle feeding; Infant; Premature; Enteral nutrition; Deglutition disorders