Laryngeal Penetration and Risk of Aspiration Pneumonia in Children with Dysphagia-A Systematic Review

Aamer Imdad; Alice G. Wang; Vaishali Adlakha; Natalie M. Crespo; Jill Merrow; Abigail Smith; Olivia Tsistinas; Emily Tanner-Smith; Rachel Rosen

doi:10.3390/jcm12124087

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Laryngeal Penetration and Risk of Aspiration Pneumonia in Children with Dysphagia-A Systematic Review

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Laryngeal Penetration and Risk of Aspiration Pneumonia in Children with Dysphagia-A Systematic Review

Aamer Imdad, Alice G. Wang, Vaishali Adlakha, Natalie M. Crespo, Jill Merrow, Abigail Smith, Olivia Tsistinas, Emily Tanner-Smith and Rachel Rosen

Journal of clinical medicine, Vol.12(12), p.4087

06/16/2023

DOI: 10.3390/jcm12124087

PMCID: PMC10299101

PMID: 37373780

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Abstract

This study was a systematic review and meta-analysis that assessed the risk of aspiration pneumonia in children with laryngeal penetration or tracheal aspiration via a video-fluoroscopic study (VFSS) and compared the results to those for children with neither condition. Systematic searches were conducted using databases, including PubMed, Cochrane Library, and Web of Science. Meta-analysis was used to obtain summary odds ratios (OR) and 95% confidence intervals (CI). The overall quality of evidence was assessed using the grading of recommendations, assessment, development, and evaluation (GRADE) criteria. In total, 13 studies were conducted with 3159 participants. Combined results from six studies showed that laryngeal penetration on VFSS may be associated with aspiration pneumonia compared to no laryngeal penetration; however, the summary estimate was imprecise and included the possibility of no association (OR 1.44, 95% CI 0.94, 2.19, evidence certainty: low). Data from seven studies showed that tracheal aspiration might be associated with aspiration pneumonia compared to no tracheal aspiration (OR 2.72, 95% CI 1.86, 3.98, evidence certainty: moderate). The association between aspiration pneumonia and laryngeal penetration through VFSS seems to be weaker than that for tracheal aspiration. Prospective cohort studies with clear definitions of laryngeal penetration and that measure clinical and patient reported outcomes are needed to further define the association between laryngeal penetration and aspiration pneumonia.

General & Internal Medicine

Life Sciences & Biomedicine

Medicine, General & Internal

Science & Technology

Details

Title: Subtitle: Laryngeal Penetration and Risk of Aspiration Pneumonia in Children with Dysphagia-A Systematic Review
Creators: Aamer Imdad - SUNY Upstate Medical University
Alice G. Wang - SUNY Upstate Medical University
Vaishali Adlakha - The University of Texas Health Science Center
Natalie M. Crespo - SUNY Upstate Medical University
Jill Merrow - SUNY Upstate Medical University
Abigail Smith - SUNY Upstate Medical University
Olivia Tsistinas - SUNY Upstate Medical University
Emily Tanner-Smith - Oregon Department of Education
Rachel Rosen - Boston Children's Hospital
Resource Type: Journal article
Publication Details: Journal of clinical medicine, Vol.12(12), p.4087
DOI: 10.3390/jcm12124087
PMID: 37373780
PMCID: PMC10299101
NLM abbreviation: J Clin Med
ISSN: 2077-0383
eISSN: 2077-0383
Publisher: Mdpi
Number of pages: 14
Language: English
Date published: 06/16/2023
Academic Unit: Stead Family Department of Pediatrics; Gastroenterology, Hepatology, Pancreatology, and Nutrition
Record Identifier: 9984446444202771

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