Department of Pediatrics, Golisano Children Hospital, SUNY Upstate Medical University, Syracuse, NY, USA.
The College of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
BMJ Open. 2021 Aug 3;11(8):e048422. doi: 10.1136/bmjopen-2020-048422.
Dysphagia affects several children in USA and around the globe. Videofluoroscopic Swallow Study (VFSS) and Fiberoptic Endoscopic Evaluation of Swallowing (FEES) are the most objective studies to define swallowing function. The presence of tracheal aspiration during VFSS or FEES in children with dysphagia is associated with an increased risk of aspiration pneumonia. However, the association of laryngeal penetration with aspiration pneumonia remains unclear. This systematic review aims to assess the risk of aspiration pneumonia in children with dysphagia with laryngeal penetration on VFSS/FEES and compare it with children with tracheal aspiration and children with neither tracheal aspiration nor laryngeal penetration.
This study will be a systematic review and meta-analysis. Systematic electronic searches will be conducted on PubMed, EMBASE, Web of Science, CINHAL, Scopus, Cochrane CENTRAL, LILACS and WHO Global Index Medicus. We will include studies published through 6 October 2021. Primary outcome will be the incidence of aspiration pneumonia. Secondary outcomes will be incidence of hospitalisation, paediatric intensive care unit admission, enteral tube requirement, growth, symptoms improvement and mortality. The Cochrane Risk of Bias In Non-Randomised Studies of Interventions tool will be used to assess the risk of bias. Meta-analysis will be used to pool the studies. We will pool dichotomous outcomes to obtain an odd ratio (OR) and report with 95% CI. Continuous outcomes will be pooled to obtain mean difference and reported with 95% CI. Overall grade of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and findings will be presented in a summary of findings table.
This study is a systematic review without contact with patients. Therefore, IRB approval is not required. Authors consent to publishing this review. Data will be kept for review by editors and peer reviewers. Data will be available to general public on request.
CRD42020222145.
在美国和全球范围内，有许多儿童患有吞咽困难。视频荧光透视吞咽研究（VFSS）和纤维光学吞咽评估（FEES）是最客观的研究方法，可以用来定义吞咽功能。在有吞咽困难的儿童中，VFSS 或 FEES 期间存在气管吸入与吸入性肺炎的风险增加有关。然而，喉咽穿透与吸入性肺炎之间的关系尚不清楚。本系统评价旨在评估 VFSS/FEES 检查中存在喉咽穿透的吞咽困难儿童发生吸入性肺炎的风险，并将其与气管吸入和既无气管吸入也无喉咽穿透的儿童进行比较。
这是一项系统评价和荟萃分析。将在 PubMed、EMBASE、Web of Science、CINHAL、Scopus、Cochrane 中心、LILACS 和世界卫生组织全球索引医学杂志上进行系统的电子检索。我们将纳入截至 2021 年 10 月 6 日发表的研究。主要结局是吸入性肺炎的发生率。次要结局为住院、儿科重症监护病房入院、肠内管需求、生长、症状改善和死亡率。将使用 Cochrane 非随机干预研究风险偏倚工具评估偏倚风险。将使用荟萃分析来汇总研究。我们将对二项式结局进行汇总，以获得比值比（OR），并报告 95%置信区间（CI）。连续结局将进行汇总，以获得均值差，并报告 95%置信区间（CI）。使用推荐评估、制定与评价（GRADE）标准对总体证据等级进行评估，并将研究结果呈现在总结表中。
本研究是一项系统评价，不与患者接触，因此不需要 IRB 批准。作者同意发表本综述。数据将保留给编辑和同行评审员审查。如有需要，数据将向公众公开。
PROSPERO 注册号：CRD42020222145。
