Screening of palatopharyngeal incoordination in mechanically ventilated critically ill infants

Abstract

Objective. Screening of palatopharyngeal incoordination in infants who required mechanical ventilation. Patients and methods. This study included 51 patients admitted to the pediatric intensive care unit (PICU), Faculty of Medicine, Ain Shams University. The study was conducted during the period from February 2021 to February 2022. All patients were divided into five groups according to the results of the Fiberoptic Flexible Endoscopic Evaluation of Swallowing (FEES) postintubation, FEES post-extubation, Videofluoroscopic Swallow Study (VFSS) post-extubation, and dye study: group 1 – not affected infants, group 2 – infants with palatopharyngeal incoordination, group 3 – infants with palatopharyngeal incoordination and gastroesophageal reflux, group 4 – infants with reflux, group 5 – infants with congenital upper air way anomalies. Results. Palatopharyngeal incoordination was detected in 16 (31.3%) patients, congenital upper airway anomalies – in 12 (23.5%) patients, and gastroesophageal reflux – in 10 (19.6%) patients. After three months, palatopharyngeal incoordination was resolved in 92.3% of patients, and 7.7 % had silent aspiration. Conclusion. Palatopharyngeal incoordination is a multifactorial process with the important implications for early diagnosis and interventions to treat this condition in pediatric patients. Key words: silent aspiration, mechanical ventilation, infants, palatopharyngeal incoordination