Physiological Basis of Neonatal Aerodigestive Difficulties in Chronic Lung Disease - 19/05/20

Doi : 10.1016/j.clp.2020.03.001

Shabih U. Hasan, MD ^a,^⁎ , Abhay K. Lodha, MD ^b, Kamran Yusuf, MD ^a, Stacey Dalgleish, RN, MN ^c
^a Department of Pediatrics, Alberta Health Services, Cumming School of Medicine, Health Sciences Centre, 3330 Hospital Drive Northwest, Calgary, Alberta T2N 4N1, Canada
^b Department of Pediatrics, Alberta Health Services, Cumming School of Medicine, Foothills Medical Centre, 1403-29th Street Northwest, Calgary, Alberta T2N 2T9, Canada
^c Neonatal Intensive Care Unit, Alberta Health Services, Cumming School of Medicine, Alberta Children’s Hospital, 28 Oki Drive Northwest, Calgary, Alberta T3B 6A8, Canada

^∗Corresponding author.

Résumé

In the United States, preterm birth rates have steadily increased since 2014. Despite the recent advances in neonatal-perinatal care, more than 40% of very low-birth-weight infants develop chronic lung disease (CLD) and almost 25% have feeding difficulties resulting in delayed achievement of full oral feeds and longer hospital stay. Establishment of full oral feeds, a major challenge for preterm infants, becomes magnified among those on respiratory support and/or with CLD. The strategies to minimize aerodigestive disorders include supporting nonnutritive sucking, developing infant-directed feeding protocols, sensory oromotor stimulation, and early introduction of oral feeds.

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Keywords : Respiratory rhythmogenesis, Central swallow pattern generator, Suck-swallow-breathe coordination, Preterm infants, Chronic lung disease, Oromotor skills, Oral feeding, Noninvasive ventilation