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J Perinatol. 2017 Apr;37(4):398-403. doi: 10.1038/jp.2016.229. Epub 2017 Jan 5.

Effect of nasal continuous positive airway pressure on the pharyngeal swallow in neonates.

Author information

1
Division of Pediatric Gastroenterology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
2
Division of Respiratory and Sleep Medicine, Children's Hospital at Montefiore, Bronx, NY, USA.
3
Department of Radiology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
4
Division of Pediatric Pulmonology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
5
Department of Biostatistics, Winthrop University Hospital, Mineola, NY, USA.
6
Department of Pediatrics, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
7
Hearing and Speech Center, Long Island Jewish Medical Center, New Hyde Park, NY, USA.
8
Division of Neonatology, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.

Abstract

OBJECTIVE:

Feeding neonates orally while on nasal continuous positive airway pressure (nCPAP) is a common practice. We hypothesize that pressurized airflow provided by nCPAP will alter the swallowing mechanism in neonates, increasing the risk of aspiration during oral feeding.

STUDY DESIGN:

Infants receiving nCPAP with a RAM cannula and tolerating at least 50% of their feeding orally were included in the study (one term; six preterm infants). Each participant underwent a videofluoroscopic swallow study while on nCPAP and off nCPAP. A non-parametric signed-rank test was used for paired data.

RESULT:

The incidence of deep penetration (P=0.03) and aspiration (P=0.01) decreased significantly off-nCPAP compared with on-nCPAP. However, the incidence of mild penetration (P=0.65) and nasopharyngeal reflux (P=0.87) remained the same under both conditions.

CONCLUSION:

Oral feeding while on-nCPAP significantly increases the risk of laryngeal penetration and tracheal aspiration events. We recommend caution when initiating oral feedings on nCPAP.

PMID:
28055023
DOI:
10.1038/jp.2016.229
[Indexed for MEDLINE]

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