The Effects of Cold Liquids on the Swallowing Mechanism in Preterm Infants
| Status: | Completed |
|---|---|
| Conditions: | Gastrointestinal |
| Therapuetic Areas: | Gastroenterology |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 2/8/2019 |
| Start Date: | December 2013 |
| End Date: | December 2015 |
A Pilot Study on The Effects of Cold Liquids on the Pharyngeal Swallow in Preterm Infants With Dysphagia.
The purpose of this study is to see if cold liquids improve the swallowing mechanisms in
premature infants with swallowing difficulties (dysphagia). The only way to objectively
diagnose dysphagia is by having that infant undergo a Video Fluoroscopic Swallow Study
(VFSS), which allows direct visualization of the liquid bolus (barium) in real time. Infants
suspected of having dysphagia and who are referred for a VFSS will be recruited for this
study. Once consented, the infant will undergo a standard VFSS. If that infant is diagnosed
with dysphagia, the study protocol will begin by keeping the infant the same position and
feeding them cold liquid barium from an identical bottle. A total of 5 swallows will be
visualized, which adds approximately 5-10 seconds to the study. Both the standard swallows
and the study swallows will be recorded for analysis and comparison. It is hypothesized that
the study swallows will have less deficits than the standard swallows. If an infant's
standard VFSS does not indicate dysphagia, that infant will no longer be eligible for this
study.
premature infants with swallowing difficulties (dysphagia). The only way to objectively
diagnose dysphagia is by having that infant undergo a Video Fluoroscopic Swallow Study
(VFSS), which allows direct visualization of the liquid bolus (barium) in real time. Infants
suspected of having dysphagia and who are referred for a VFSS will be recruited for this
study. Once consented, the infant will undergo a standard VFSS. If that infant is diagnosed
with dysphagia, the study protocol will begin by keeping the infant the same position and
feeding them cold liquid barium from an identical bottle. A total of 5 swallows will be
visualized, which adds approximately 5-10 seconds to the study. Both the standard swallows
and the study swallows will be recorded for analysis and comparison. It is hypothesized that
the study swallows will have less deficits than the standard swallows. If an infant's
standard VFSS does not indicate dysphagia, that infant will no longer be eligible for this
study.
Swallowing is a complex task that takes place in the mouth and throat. It involves tiny
receptors that gather sensory information about the liquid. Those receptors send a sensory
message to the brain, where it is processed. The brain then sends back motor messages to the
muscles in the throat regarding what kind of motor movements to do in order to swallow that
liquid safely. The motor movements must be carefully timed and coordinated to safely swallow
the liquid with out it going near, or into the lungs. When the liquid goes down the wrong
tube, or into the lungs, it is called aspiration.
Some infants that are born prematurely end up with swallowing problems when drinking from a
bottle. This problem can lead to liquid, such as formula or breastmilk, to be aspirated. This
is due to the infant's poor coordination of all the muscles needed to safely swallow.
Researchers have found that changing the sensory characteristics of the liquid alters the
motor movements of the swallow. This is because the sensory receptors respond differently to
different types if liquids. Studies using adults with swallowing problems has shown that
swallowing cold liquids improves some of the swallowing difficulties. Based off of these
observations, there are currently several therapies used in Neonatal Intensive Care Units
(NICU) nationwide which use cold stimulation to improve swallowing in prematurely born
infants, although, there has been no research studies proving it actually works.
The purpose of this study is to assess the effect of cold liquid on the swallow mechanism in
preterm infants with swallowing difficulties. A video x-ray procedure, called a
Videofluoroscopic Swallow Study (VFSS), is considered the gold standard when assessing the
motor movements present in the throat when swallowing. The standard procedure for an infant
VFSS involves bottle feeding room temperature liquid barium while looking at the swallow
movements obtained from the video x-ray images. After consent is obtained, infants who are
assumed to have swallowing difficulties will undergo a "standard" VFSS. If during the study
they are found to have swallowing problems, the study protocol will then begin by introducing
cold liquid barium from an identical bottle. A total of 5 swallows will be looked at and
recorded for review at a later time. The standard procedure for that infant's VFSS will then
continue.
The hypothesis is that cold liquids will improve the swallowing movements in premature
infants with swallowing difficulty. Information gathered will support the use of cold liquids
and cold stimulation in NICUs to help benefit these infants.
receptors that gather sensory information about the liquid. Those receptors send a sensory
message to the brain, where it is processed. The brain then sends back motor messages to the
muscles in the throat regarding what kind of motor movements to do in order to swallow that
liquid safely. The motor movements must be carefully timed and coordinated to safely swallow
the liquid with out it going near, or into the lungs. When the liquid goes down the wrong
tube, or into the lungs, it is called aspiration.
Some infants that are born prematurely end up with swallowing problems when drinking from a
bottle. This problem can lead to liquid, such as formula or breastmilk, to be aspirated. This
is due to the infant's poor coordination of all the muscles needed to safely swallow.
Researchers have found that changing the sensory characteristics of the liquid alters the
motor movements of the swallow. This is because the sensory receptors respond differently to
different types if liquids. Studies using adults with swallowing problems has shown that
swallowing cold liquids improves some of the swallowing difficulties. Based off of these
observations, there are currently several therapies used in Neonatal Intensive Care Units
(NICU) nationwide which use cold stimulation to improve swallowing in prematurely born
infants, although, there has been no research studies proving it actually works.
The purpose of this study is to assess the effect of cold liquid on the swallow mechanism in
preterm infants with swallowing difficulties. A video x-ray procedure, called a
Videofluoroscopic Swallow Study (VFSS), is considered the gold standard when assessing the
motor movements present in the throat when swallowing. The standard procedure for an infant
VFSS involves bottle feeding room temperature liquid barium while looking at the swallow
movements obtained from the video x-ray images. After consent is obtained, infants who are
assumed to have swallowing difficulties will undergo a "standard" VFSS. If during the study
they are found to have swallowing problems, the study protocol will then begin by introducing
cold liquid barium from an identical bottle. A total of 5 swallows will be looked at and
recorded for review at a later time. The standard procedure for that infant's VFSS will then
continue.
The hypothesis is that cold liquids will improve the swallowing movements in premature
infants with swallowing difficulty. Information gathered will support the use of cold liquids
and cold stimulation in NICUs to help benefit these infants.
Inclusion Criteria:
- Infants born prematurely, as defined by birth at less than 37 weeks gestational age,
referred for a videofluoroscopic swallow study (VFSS) due to suspected pharyngeal
phase dysphagia.
Exclusion Criteria:
- Infants born prematurely with a corrected gestational age of 43 weeks or greater.
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Winthrop University Hospital Founded in 1896 by a group of local physicians and concerned citizens,...
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