Feeding of children with tracheostomy at hospital discharge
Forma de alimentação de crianças com traqueostomia na alta hospitalar
Caroline Stefani Dias Basso; Marta Alves da Silva Arroyo; Patrícia da Silva Fucuta; Aline Barbosa Maia
Abstract
Purpose: to describe the work of speech-language-hearing therapists and verify which was the most prevalent feeding method in the sample studied.
Methods: a descriptive observational study based on data surveyed from medical records. The following variables were used: age, medical diagnosis, hospital ward, feeding method before and after the tracheostomy, time of speech-language-hearing care, and speech-language-hearing discharge. The data were submitted to descriptive statistical analysis with the appropriate tests to compare the categorical variables. All infants and children with tracheostomy performed either before or during hospital stay between July 2017 and July 2018, who received speech-language-hearing care upon request of the physician, were included.
Results: a total of 51 children took part in the study, most of whom were males (56.9%), with a median age of 12 months, ranging from 1 month to 12 years old at the time of the speech-language-hearing assessment. The feeding methods at hospital discharge were described as follows: full oral feeding (37%), partial oral feeding (25.5%), nasogastric/nasoenteral tube (19.6%), and gastrostomy (17.6%).
Conclusion: the full oral diet of tracheostomized children was the most prevalent feeding method at hospital speech-language-hearing discharge.
Keywords
Resumo
Objetivo: descrever o trabalho fonoaudiológico e verificar qual forma de alimentação foi mais prevalente dentro da amostra estudada.
Métodos: trata-se de um estudo observacional descritivo, realizado por meio de levantamento de dados nos prontuários, onde buscou-se as seguintes variáveis: idade, diagnóstico médico, setor de internação, forma de alimentação antes e após traqueostomia, período de atendimento fonoaudiológico e alta fonoaudiológica. Os dados foram submetidos à análise estatística descritiva, tendo sido utilizados testes pertinetes para a comparação de variáveis categóricas. Foram incluídos no estudo todos os lactentes e crianças traqueostomizadas com traqueostomia prévias ou realizadas durante internação, no período de julho de 2017 a julho de 2018, que receberam atendimento fonoaudiológico mediante solicitação médica.
Resultados: cinquenta e uma crianças foram incluídas no estudo. A maioria das crianças era do sexo masculino (56,9%) e a idade mediana foi de 12 meses, com variação de 01 mês de vida a 12 anos de idade, no momento da avaliação fonoaudiológica. A forma de alimentação na alta fonoaudiológica hospitalar foi descrita em: via oral exclusiva (37%), via oral parcial (25,5%), sonda nasogástrica/nasoenteral (19,6%) e gastrostomia (17,6%).
Conclusão: foi possível observar que a dieta por via oral de maneira exclusiva foi a forma de alimentação de maior prevalência na alta fonoaudiológica hospitalar.
Palavras-chave
Referencias
. Butnaru CS, Colreavy MP, Ayari S, Froehlich P. Tracheotomy in children: evolution in indications. Int J Pediatr. Otorhinolaryngol. [journal on the Internet]. 2006 [accessed on 2021 Apr 03];70:115-9. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0165587605002806?via%3Dihub
2. Fraga JC, Souza JCK, Kruel J. Pediatric tracheostomy. J Pediatr (RJ). [journal on the Internet]. 2009 [accessed on 2021 Apr 03];85(2):97-103. Available at: https://www.scielo.br/pdf/jped/v85n2/en_v85n2a03.pdf
3. Tutor JD, Gosa MM. Dysphagia and aspiration in children. Pediatr Pulmonol. [journal on the Internet]. 2012 [accessed on 2021 Apr 03];47:321-37. Available at: https://onlinelibrary.wiley.com/doi/epdf/10.1002/ppul.21576
4. Bone DK, Davis JL, Zuidema JD, Cameron JL. Aspiration pneumonia: Prevention of aspiration in patients with tracheostomies. Ann. Thorac. Surg. [journal on the Internet]. 1974 [accessed on 2021 Apr 03];18(1):30-7. Available at: https://www.annalsthoracicsurgery.org/article/S0003-4975(10)65714-1/pdf
5. Pannunzio TG. Aspiration of oral feedings in patients with tracheostomies. AACN ClinIssues. [journal on the Internet]. 1996 [accessed on 2021 Apr 03];7(4):560-9. Available at: https://pubmed.ncbi.nlm.nih.gov/8970257/
6. Rudolph CD, Link DT. Feeding disorders in infants and children. Pediatr. Clin. [journal on the Internet] 1994 [accessed on 2021 Apr 03];49(1):97-112 (vi). Available at: https://pubmed.ncbi.nlm.nih.gov/7983566/.
7. Arvedson JC. Management of pediatric dysphagia. Otolaryngol. Clin. [journal on the Internet]. 1998 [accessed on 2021 Apr 03];31(3):453-76. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0030666505700645?via%3Dihub
8. Arvedson JC. Evaluation of children with feeding and swallowing problems. Lang. Speech Hear. Serv. Sch. [journal on the Internet]. 2000 [accessed on 2021 Apr 03];31(1):28-41. Available at: https://pubs.asha.org/doi/pdf/10.1044/0161-1461.3101.28
9. Tutor JD, Srinivasan S, Gosa MM, Spentzas T, Stokes DC. Pulmonary function in infants with swallowing dysfunction. PLoS One. [journal on the Internet]. 2015 [accessed on 2021 Apr 03];10(5):1-12 Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4433327/pdf/pone.0123125.pdf
10. Picinin IFM, Bittencourt PFS, Bié IMG, Tavares LAF, Mesquita TCL, Lopes AD, Nascimento NG. Modelo de assistência multidisciplinar à criança traqueostomizada. Rev Med Minas Gerais. [journal on the Internet]. 2016 [accessed on 2021 Apr 03]; 26(Supl 6):S19-S26. Available at: http://rmmg.org/artigo/detalhes/1984
11. Macedo E, Gomes GF, Furkin AM. A deglutição normal. In: Gomes FF, Furkin AM, Macedo E, editors. Manual de cuidados do paciente com disfagia. Sao Paulo: Lovise; 2000. Cap 02. p. 17-27.
12. Barros APB, Portas JG, Queija, DS. Implicações da traqueostomia na comunicação e na deglutição. Rev Bras Cir Cabeça Pescoço. [journal on the Internet]. 2009 [accessed on 2021 Apr 03];202-7. Available at: http://www.fonovim.com.br/arquivos/e3ea46e68c92e587ac9cec2085b7f180-Implica----es-da-traqueostomia-na-comunica----o.pdf
13. Belafsky PC, Blumenfeld L, Lepage AA, Nahrstedt K. The accuracy of the modified Evan´s Blue Dye Test in predicting aspiration. The Laryngoscope. [journal on the Internet]. 2010 [accessed on 2021 Apr 03]; 113:1969-72. Available at: https://onlinelibrary.wiley.com/doi/abs/10.1097/00005537-200311000-00021
14. Levy DS, Almeida ST. Contribuição da avaliação fonoaudiológica para o delineamento da intervenção na disfagia pediátrica. In: Levy DS, Almeida ST, editors. Disfagia infantil. 1.Ed. Rio de Janeiro, RJ: Thieme Revinter Publicações, 2018.p.73-84.
15. ASHA: American Speech-Language-Hearing Association. [Internet]. 2000 Clinical indicators for instrumental assessment of dysphagia [Guidelines]. ASHA Practice Policy. Available at: http://www.asha.org/policy/GL2000-00047.htm
16. Barros APB, Carrara-de-Angelis E. Avaliação fonoaudiológica à beira leito. In: Jotz GP, Carrara-De-Angelis E, Barros APB, editors. Tratado da deglutição e disfagia: no adulto e na criança. Rio de Janeiro, Revinter, 2009. p.68-70.
17. Flabiano-Almeida FC, Búhler KEB, Limongi SCO. Protocolo para avaliação clínica da disfagia pediátrica (PAD-PED). 2014. Barueri (SP); Pro-Fono.
18. Lima AH, Côrtes MG, Bouzada MCF, Friche AAL. Preterm newborn readiness for oral feeding: systematic review and metaanalysis. CoDAS [journal on the Internet]. 2015 [accessed on 2021 Apr 03];27(1):101-7. Available at: https://www.scielo.br/j/codas/a/vbRbKy67yYXBPCvN8TwZyJn/?lang=en&format=pdf
19. Paião RCN, Dias LIN. A atuação da fisioterapia nos cuidados paliativos da criança com câncer. Ensaios e Ciência. Ciências Biológias, Agrárias e da Saúde. [jornal on the Internet]. 2013 [accessed on 2021 Apr 03];16(4). Available at: http://pgsskroton.com.br/seer/index.php/ensaioeciencia/article/view/2777/2633
20. Moura RGF, Cunha DA, Caldas ASC, Silva HJ. Quantitative evaluation of taste in childhood populations: a systematic review. Brazil J Otorhinolaryngol. [journal on the Internet]. 2014 [accessed on 2021 Apr 03];81(1):97-106. Available at: http://www.scielo.br/pdf/bjorl/v81n1/1808-8694-bjorl-81-01-00097.pdf
21. Conover WJ. Practical nonparametric statistics. New York: John Wiley & Sons, 1998.
22. Siegel S, Castellan Jr NJ. Estatística Não Paramétrica para Ciências do Comportamento. Bookman, 2ª edição, São Paulo, 2006.
23. Fraga JC, Souza JCK, Kruel J. Pediatric tracheostomy. Jornal de Pediatria. [jornal on the Internet]. 2009 [accessed on 2021 Apr 20];85(2). Available at: https://www.scielo.br/pdf/jped/v85n2/en_v85n2a03.pdf
24. Maunsell R, Avelino M, Alves JC, Semenzati G, Lubianca Neto JF, Krumenauer R et al. Revealing the needs of children with tracheostomies. European Annals of Otorhinolaryngology, Head and Neck diseases. [journal on the Internet]. 2018 [accessed on 2021 Apr 20];135S:S93–S97. Available at: https://www.sciencedirect.com/science/article/pii/S1879729618301248?via%3Dihub
25. Bhattacharyya N. The prevalence of pediatric voice and swallowing problems in the United States. Laryngoscope [journal on the Internet]. 2015 [accessed on 2021 Apr 20];125(3):746-50. Available at: https://doi.org/10.1002/lary.24931
26. Svystun O, Johannsen W, Persad R, Turner JM, Majaesic C, El-Haquim H. Dysphagia in healthy children: characteristics and management of a consecutive cohort at a tertiary centre. Int J Pediatr Otorhinolaryngol [journal on the Internet]. 2017 [accessed on 2021 Apr 20];99:54-9. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0165587617302434?via%3Dihub
27. Pavithran J, Puthiyottil IV, Narayan M, Vidhyadharan S, Menon JR, Iyer S. Observations from a pediatric dysphagia clinic: characteristics of children at risk of aspiration pneumonia. The Laryngoscope. [journal on the Internet]. 2019 [accessed on 2021 Apr 20];129:2614-8. Available at: https://onlinelibrary.wiley.com/doi/full/10.1002/lary.27654
28. Taniguchi MH, Moyer RS. Assessment of risk factors for pneumonia in dysphagic children: significance of videofluoroscopic swallowing evaluation. Dev Med Child Neurol. [journal on the Internet]. 1994 [accessed on 2021 Apr 20];36:495–502. Available at: https://doi.org/10.1111/j.1469-8749.1994.tb11879.x
29. Lefton-Greif MA, McGrath-Morrow SA. Deglutition and respiration: development, coordination, and practical implications. Semin Speech Lang. [journal on the Internet]. 2007 [accessed on 2021 Apr 20];28(3):166-79. Available at: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2007-984723
30. Heckathorn DE, Speyer R, Taylor J, Cordier R. Systematic review: non-instrumental swallowing and feeding assessments in pediatrics. Dysphagia. [journal on the Internet]. 2021 [accessed on 2021 Apr 20];31(1):1-23. Available at: https://link.springer.com/article/10.1007/s00455-015-9667-5
31. Costa SP, Van der Schans CP. The reliability of the neonatal oral-motor assessment scale, Acta Paediatr. [journal on the Internet]. 2008 [accessed on 2021 Apr 20];97(1):21-6. Available at: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1651-2227.2007.00577.x
32. Engel-Hoek LV, Hulst KCMV, Gerven MHJC, Haaften LV, Groot SF. Development of oral motor behavior related to the skill assisted spoon feeding, Infant Behav. Dev. [journal on the Internet]. 2014 [accessed on 2021 Apr 20];37(2):187-91. Available at: https://www.sciencedirect.com/science/article/pii/S0163638314000137
33. Streppela M, Vedera LL, Pullensa B, Joostenb KFM. Swallowing problems in children with a tracheostomy tube. International Journal of Pediatric Otorhinolaryngology. [journal on the Internet]. 2019 [accessed on 2021 Apr 20]; 124:30-3. Available at: https://doi.org/10.1016/j.ijporl.2019.05.003
Submitted date:
03/05/2021
Accepted date:
03/09/2021
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