A Retrospective Examination of Prandial Aspiration in Preterm Infants

Abstract

PurposeWe conducted this retrospective study to identify potential signs of aspiration in preterm infants based on crib-side nursing documentation.Study Design and MethodsA total of 2,590 bottle-feedings were examined for signs of distress across 41 preterm infants who were referred for a swallowing evaluation. All infants underwent either a videofluoroscopic swallow study (VSS) or upper gastrointestinal study (GIS). Physiologic and behavioral warning signs were coded across feedings 10 days prior to the imaging study. Presence or absence of documented aspiration during VSS/GIS was coded for each infant.ResultsDistress signs were documented in seven percent of oral feeding attempts. Aspiration was more common when the crib-side nurse documented coughing (LR+, 8.77; 95% CI, .99–77.09), compromised oxygen saturation levels (LR+, 2.15; CI, .86–5.47), and tachypnea (LR+, 2.15; CI, .28–3.01) during bottle-feeding.Clinical ImplicationsEvidence-based distress signs that signal increased suspicion for prandial aspiration will facilitate correct clinical judgments at crib-side. Early identification and prevention of prandial aspiration improves health outcomes for preterm infants.