Suterwala M S, Reynolds J, Carroll S, Sturdivant C, Armstrong E S
Division of Neonatology, Department of Pediatrics, Baylor University Medical Center, Dallas, TX, USA.
Department of Physical Medicine, Baylor University Medical Center, Dallas, TX, USA.
J Perinatol. 2017 Apr;37(4):404-408. doi: 10.1038/jp.2016.239. Epub 2017 Jan 5.
To evaluate the safety of fiberoptic endoscopic evaluation of swallowing (FEES) and the reliability of both FEES and a videofluoroscopic swallowing study (VFSS) in identifying laryngeal penetration and tracheal aspiration in infants under 3 months old in the neonatal intensive care unit (NICU).
Twenty-five infants at least 37 weeks postmenstrual age suspected of aspirating were assessed with FEES and VFSS. Complications, autonomic instability and vital signs before endoscope insertion and following FEES were documented. Blinded video recordings were coded by two reviewers to determine reliability.
We found no major complications or significant differences between FEES prefeeding and postfeeding vital signs, including respiratory rate, heart rate or oxygen saturation. FEES interrater reliability was 80% for both penetration and aspiration, compared with 87 and 90%, respectively, for VFSS.
FEES is safe and reliable in assessing laryngeal penetration and tracheal aspiration in NICU infants.
评估纤维光学吞咽内镜检查（FEES）的安全性，以及FEES和电视荧光吞咽造影检查（VFSS）在识别新生儿重症监护病房（NICU）中3个月以下婴儿的喉穿透和气管误吸方面的可靠性。
对25名孕龄至少37周且疑似有误吸情况的婴儿进行了FEES和VFSS评估。记录了内镜插入前及FEES后出现的并发症、自主神经不稳定情况和生命体征。由两名审阅者对未标注信息的视频记录进行编码以确定可靠性。
我们发现，FEES喂食前和喂食后的生命体征（包括呼吸频率、心率或血氧饱和度）之间没有重大并发症或显著差异。FEES评估者间在穿透和误吸方面的可靠性为80%，而VFSS分别为87%和90%。
FEES在评估NICU婴儿的喉穿透和气管误吸方面是安全可靠的。
