Trastornos de la deglución en niños menores de 3 años con condiciones médicas complejas, abordaje interdisciplinario

Abstract

Children with swallowing disorders (SD) may manifest symptoms at all times during feeding. This clinical entity can present itself in different grades and forms. ObjectiveTo diagnose and intervene in SD and/or eating behavior (EB) in children with complex chronic medical conditions referred to an interdisciplinary team, during 2017, in a high complexity hospital. Material and methodsAnalytical, prospective and longitudinal study with the intervention of an interdisciplinary team. Clinical phonoaudiological evaluation of swallowing was performed, offering guidelines for stimulation and consistency modification. Results139 patients, between 2 month and 3 years old, 38% women, 77% with enteral nutritional support (ENS) were evaluated, 73% presented SD exclusively or associated with an EB. The 38% who entered with ENS achieved weaning (without significant difference between those who had or not SD, P=.85, and those who had or not tracheotomy, P=.88), and of the group that did not achieve weaning, oral contribution increased in 54% of cases. A statistically significant difference was observed in weaning of patients who attended the interdisciplinary space with respect to those who did not (P=.016) and longer intervention time between those who achieved weaning and those who did not, 5.2±3.1 vs 3.45±3.1 months (P=.0099). And 70% off patients continued follow with the speech therapist. ConclusionInterdisciplinary and specialized work in this subject is essential in children with complex medical conditions. In cases of SD, speech therapy intervention, it is assumed as essential for early detection and correct approach to dysphagia.