Vocal cord dysfunction and feeding difficulties after pediatric cardiovascular surgery

被引:81
作者
Sachdeva, Ritu
Hussain, Elora
Moss, M. Michele
Schmitz, Michael L.
Ray, Richard M.
Imamura, Michiaki
Jaquiss, Robert D. B.
机构
[1] Univ Arkansas Med Sci, Arkansas Childrens Hosp, Dept Pediat, Div Pediat Cardiol, Little Rock, AR 72205 USA
[2] Univ Arkansas Med Sci, Arkansas Childrens Hosp, Dept Anesthesiol, Little Rock, AR 72205 USA
关键词
D O I
10.1016/j.jpeds.2007.03.014
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To evaluate the impact of vocal cord dysfunction on feeding in children after cardiovascular surgery. Study design Of the 2255 children who had cardiovascular surgery between January 2000 to January 2006, 38 (1.7%) had postoperative vocal cord dysfunction confirmed at laryngoscopy. The following data were obtained retrospectively: type of surgery. laryugoscopic examination results, swallowing studies, upper gastrointestinal (UGI) studies, and feeding route: oral, nasogastric tube (NG), and gastrostomy. Results Surgeries included aortic arch reconstruction (n = 20), patent ductus arteriosus ligation (n = 8), arterial switch (n = 3), cervical cannulation for extracorporeal membrane oxygenation (n = 2). and others (n = 5). A swallowing study confirmed dysfunction in 27 of 29 patients. Gastrostomy was placed in 18/38 patients. At discharge, 18 patients were fed by gastrostomy, 13 orally, 3 by NG, and 4 by combination oral/NG. At a median follow-up of 12 months, 20 were fed orally, 1 by NG, 7 by gastrostomy, 7 by combination gastrostomy/orally, I was lost to follow-up, 2 died. Conclusion Vocal cord dysfunction after pediatric cardiovascular surgery is associated with significant feeding problems kind may require prolonged gastrostomy feeding. These findings support aggressive surveillance for vocal cord dysfunction, especially in patients undergoing aortic arch surgery.
引用
收藏
页码:312 / 315
页数:4
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