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长期使用呼吸机的儿童的喂养和吞咽结果:一项范围综述。

Feeding and Swallowing Outcomes in Children Who Use Long-Term Ventilation: A Scoping Review.

作者信息

Lee Sabrena, Marshall Jeanne, Clarke Michael, Smith Christina H

机构信息

Evelina London Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.

Faculty of Brain Sciences, University College London, London, UK.

出版信息

Dysphagia. 2024 Aug;39(4):666-683. doi: 10.1007/s00455-023-10648-0. Epub 2024 Jan 5.

Abstract

The last two decades have seen increasing use of long-term ventilation (LTV) as an intervention in childhood. Children who use LTV have many risk factors for feeding and swallowing difficulties, including their underlying respiratory and/or neurological etiology, long hospitalizations, medical interventions, and limited exposure to oral feeding experiences. This review aimed to answer two questions: 1) 'What specific swallowing and feeding characteristics do these children experience?'; and 2) 'What impacts do these swallowing and feeding characteristics have on health status and quality of life?'. Texts were identified across bibliographic databases, reference lists, and grey literature. Studies were analyzed according to ventilation, feeding and swallowing, assessment and intervention, and quality of life parameters. Overall, 1919 papers were screened, with 31 papers included in the final data extraction process. A range of feeding and swallowing characteristics were observed, including oral secretion management difficulties, oral aversion, swallowing difficulties, and clinical signs of aspiration. Non-oral feeding was found to be the primary feeding method used. Little information on health status and quality of life was reported in scoping review texts. Children with LTV needs present with a range of feeding and swallowing concerns, and non-oral feeding is common. Further research is needed to understand the feeding and swallowing journey of this population. This will assist in future service planning and delivery, and in turn contribute to improving patient outcomes and quality of life.

摘要

在过去二十年中,长期通气(LTV)作为一种针对儿童的干预措施,其使用频率不断增加。使用LTV的儿童存在许多导致喂养和吞咽困难的风险因素,包括潜在的呼吸和/或神经病因、长期住院、医疗干预以及口腔喂养经历有限。本综述旨在回答两个问题:1)“这些儿童有哪些具体的吞咽和喂养特征?”;2)“这些吞咽和喂养特征对健康状况和生活质量有何影响?”。通过书目数据库、参考文献列表和灰色文献确定相关文本。根据通气、喂养和吞咽、评估和干预以及生活质量参数对研究进行分析。总体而言,共筛选了1919篇论文,最终有31篇论文纳入数据提取过程。观察到一系列喂养和吞咽特征,包括口腔分泌物管理困难、口腔厌恶、吞咽困难以及误吸的临床体征。发现非口腔喂养是主要的喂养方式。在范围综述文本中,关于健康状况和生活质量的信息报道较少。LTV需求儿童存在一系列喂养和吞咽问题,非口腔喂养很常见。需要进一步研究以了解这一人群的喂养和吞咽过程。这将有助于未来的服务规划和提供,进而有助于改善患者预后和生活质量。

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