Lung ultrasound supports clinical evaluation of feeding competence development in preterm neonates
IntroductionThe achievement of alimentary competencies is a milestone in the development of preterm neonates. Ten percent of neonates <37 weeks of gestational age and 25% of those VLBW experience swallowing disorders, with an increased risk of problems in the early phase of life (failure to t...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1222473/full |
| _version_ | 1797679170062385152 |
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| author | Tiziana Controzzi Francesca Chesi Rosa Teresa Scaramuzzo Matteo Giampietri Riccardo Morganti Simona Fiori Simona Fiori Elena Moretti Luna Gargani Luca Filippi Luca Filippi |
| author_facet | Tiziana Controzzi Francesca Chesi Rosa Teresa Scaramuzzo Matteo Giampietri Riccardo Morganti Simona Fiori Simona Fiori Elena Moretti Luna Gargani Luca Filippi Luca Filippi |
| author_sort | Tiziana Controzzi |
| collection | DOAJ |
| description | IntroductionThe achievement of alimentary competencies is a milestone in the development of preterm neonates. Ten percent of neonates <37 weeks of gestational age and 25% of those VLBW experience swallowing disorders, with an increased risk of problems in the early phase of life (failure to thrive, growth retardation, inhalation, and consequent risk of pulmonary infection) and later in life due to delayed development of oromotor skills.The main diagnostic tools for swallowing disorders are endoscopic (fiber-optic endoscopic examination of swallowing, FEES) or radiographic (videofluoroscopic swallowing study, VFSS) exams. Given the invasiveness of these methods and the bias due to rheologic differences between bolus and contrast medium, FEES and VFSS are poorly reproducible. Moreover, neither of the technique is capable of detecting post-meal inhalations, especially microinhalations or those consequent to a whole meal rather than to a single swallowing.Lung ultrasound (LUS) is a widespread, repeatable, safe, fast point-of-care tool and we reported previous encouraging results in detecting silent and overt inhalation related to the meal in children with dysphagia/gastroesophageal reflux disease (GERD) risk factors.MethodsWe report a pilot study, that investigated LUS approach (performing imaging before and after meals) to assess feeding competence development in a cohort of n. 19 newborns <32 weeks of age.ResultsMeal monitoring by LUS did not show any significant difference in scoring before/after eating. The achievement of full enteral feeding correlates with GA at birth (p < 0.001) but not with LUS scoring. The introduction of the first meal by bottle correlates both with gestational age (p < 0.001) and ultrasound scores (p = 0.004). LUS score at 7 days of life resulted predictive for length of invasive/non-invasive respiratory support (p = 0.002) and length of oxygen supply (p = 0.001), while LUS score at 48 h of life did not (p n.s.).DiscussionOur study suggests that the development of oral feeding skills is not strictly dependent on gestational age. Moreover, our research suggests the predominant role of LUS in predicting the time of readiness to oral feeding, as the LUS score can be a marker of respiratory and lung wellness, and consequently a predictor of neonate stability during deglutitory apnea. |
| first_indexed | 2024-03-11T23:10:43Z |
| format | Article |
| id | doaj.art-98affa8be27643ae90823876e49249da |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-11T23:10:43Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-98affa8be27643ae90823876e49249da2023-09-21T09:05:20ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-09-011110.3389/fped.2023.12224731222473Lung ultrasound supports clinical evaluation of feeding competence development in preterm neonatesTiziana Controzzi0Francesca Chesi1Rosa Teresa Scaramuzzo2Matteo Giampietri3Riccardo Morganti4Simona Fiori5Simona Fiori6Elena Moretti7Luna Gargani8Luca Filippi9Luca Filippi10U.O. Neonatologia, Dipartimento Materno-Infantile, Azienda Ospedaliero Universitaria Pisana, Pisa, ItalyU.O. Neonatologia, Dipartimento Materno-Infantile, Azienda Ospedaliero Universitaria Pisana, Pisa, ItalyU.O. Neonatologia, Dipartimento Materno-Infantile, Azienda Ospedaliero Universitaria Pisana, Pisa, ItalyU.O. Neonatologia, Dipartimento Materno-Infantile, Azienda Ospedaliero Universitaria Pisana, Pisa, ItalySezione di Statistica, Azienda Ospedaliero Universitaria Pisana, Pisa, ItalyDipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, ItalyIRCCS Fondazione Stella Maris, Calambrone, ItalyIRCCS Fondazione Stella Maris, Calambrone, ItalyDepartment of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, ItalyU.O. Neonatologia, Dipartimento Materno-Infantile, Azienda Ospedaliero Universitaria Pisana, Pisa, ItalyDipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, ItalyIntroductionThe achievement of alimentary competencies is a milestone in the development of preterm neonates. Ten percent of neonates <37 weeks of gestational age and 25% of those VLBW experience swallowing disorders, with an increased risk of problems in the early phase of life (failure to thrive, growth retardation, inhalation, and consequent risk of pulmonary infection) and later in life due to delayed development of oromotor skills.The main diagnostic tools for swallowing disorders are endoscopic (fiber-optic endoscopic examination of swallowing, FEES) or radiographic (videofluoroscopic swallowing study, VFSS) exams. Given the invasiveness of these methods and the bias due to rheologic differences between bolus and contrast medium, FEES and VFSS are poorly reproducible. Moreover, neither of the technique is capable of detecting post-meal inhalations, especially microinhalations or those consequent to a whole meal rather than to a single swallowing.Lung ultrasound (LUS) is a widespread, repeatable, safe, fast point-of-care tool and we reported previous encouraging results in detecting silent and overt inhalation related to the meal in children with dysphagia/gastroesophageal reflux disease (GERD) risk factors.MethodsWe report a pilot study, that investigated LUS approach (performing imaging before and after meals) to assess feeding competence development in a cohort of n. 19 newborns <32 weeks of age.ResultsMeal monitoring by LUS did not show any significant difference in scoring before/after eating. The achievement of full enteral feeding correlates with GA at birth (p < 0.001) but not with LUS scoring. The introduction of the first meal by bottle correlates both with gestational age (p < 0.001) and ultrasound scores (p = 0.004). LUS score at 7 days of life resulted predictive for length of invasive/non-invasive respiratory support (p = 0.002) and length of oxygen supply (p = 0.001), while LUS score at 48 h of life did not (p n.s.).DiscussionOur study suggests that the development of oral feeding skills is not strictly dependent on gestational age. Moreover, our research suggests the predominant role of LUS in predicting the time of readiness to oral feeding, as the LUS score can be a marker of respiratory and lung wellness, and consequently a predictor of neonate stability during deglutitory apnea.https://www.frontiersin.org/articles/10.3389/fped.2023.1222473/fullpreterm infantslung ultrasoundfeedingdeglutitory apneainhalationgastroesophageal reflux |
| spellingShingle | Tiziana Controzzi Francesca Chesi Rosa Teresa Scaramuzzo Matteo Giampietri Riccardo Morganti Simona Fiori Simona Fiori Elena Moretti Luna Gargani Luca Filippi Luca Filippi Lung ultrasound supports clinical evaluation of feeding competence development in preterm neonates Frontiers in Pediatrics preterm infants lung ultrasound feeding deglutitory apnea inhalation gastroesophageal reflux |
| title | Lung ultrasound supports clinical evaluation of feeding competence development in preterm neonates |
| title_full | Lung ultrasound supports clinical evaluation of feeding competence development in preterm neonates |
| title_fullStr | Lung ultrasound supports clinical evaluation of feeding competence development in preterm neonates |
| title_full_unstemmed | Lung ultrasound supports clinical evaluation of feeding competence development in preterm neonates |
| title_short | Lung ultrasound supports clinical evaluation of feeding competence development in preterm neonates |
| title_sort | lung ultrasound supports clinical evaluation of feeding competence development in preterm neonates |
| topic | preterm infants lung ultrasound feeding deglutitory apnea inhalation gastroesophageal reflux |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1222473/full |
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