Quantification of the source, amount and duration of aspiration in the lungs of infants using gamma scintigraphy

Beth L Laube; Richard Katz; Gerald M Loughlin; Jeanne M Pinto; Maureen A Lefton-Greif

doi:10.1016/j.prrv.2019.03.006

Quantification of the source, amount and duration of aspiration in the lungs of infants using gamma scintigraphy

Paediatr Respir Rev. 2019 Nov:32:23-27. doi: 10.1016/j.prrv.2019.03.006. Epub 2019 Apr 4.

Authors

Beth L Laube¹, Richard Katz², Gerald M Loughlin³, Jeanne M Pinto², Maureen A Lefton-Greif²

Affiliations

¹ Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA. Electronic address: blaube@jhmi.edu.
² Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
³ Department of Pediatrics, Weill Medical College of Cornell University, New York, USA.

PMID: 31005455
DOI: 10.1016/j.prrv.2019.03.006

Abstract

Background: Aspiration can cause acute symptoms and chronic lung disease in the developing lung. However, the source of aspiration in infants is often unclear, making the choice of intervention difficult.

Objective: To quantify the source, amount and duration of lung aspiration in infants using gamma scintigraphy.

Methods: Two infants with clinical evidence of gastroesophageal reflux and oropharyngeal dysphagia swallowed formula radiolabeled with ^99mtechnetium on Visit 1. Radiolabeled-formula was instilled by nasogastric tube on Visit 2. Lung aspiration was quantified over four hours and expressed as percent of total radioactivity administered.

Results: Aspiration was greatest with swallowing, compared to instillation, peaking between 2.0% and 2.4% within 30 min and between 0.40% and 0.65% within 20 min, respectively. Radioactivity remained above zero four hours after either administration.

Conclusions: Quantification of the source, amount and duration of lung aspiration in infants is feasible using gamma scintigraphy. The impact of aspiration accrual on clinical care deserves further investigation.

Keywords: Gamma scintigraphy; Gastroesophageal reflux; Lung aspiration; Oropharyngeal dysphagia.

MeSH terms

Deglutition Disorders / diagnostic imaging*
Deglutition*
Gastroesophageal Reflux / diagnostic imaging*
Humans
Infant
Intubation, Gastrointestinal
Male
Radionuclide Imaging / methods
Radiopharmaceuticals
Respiratory Aspiration / diagnostic imaging*
Respiratory Aspiration of Gastric Contents / diagnostic imaging*
Technetium Tc 99m Sulfur Colloid

Substances

Radiopharmaceuticals
Technetium Tc 99m Sulfur Colloid