title: Using fiberoptic endoscopic evaluation of swallowing to detect laryngeal penetration and aspiration in infants in the neonatal intensive care unit.
abstract: To evaluate the safety of fiberoptic endoscopic evaluation of swallowing (FEES) and the reliability of both FEES and a videofluoroscopic swallowing study (VFSS) in identifying laryngeal penetration and tracheal aspiration in infants under 3 months old in the neonatal intensive care unit (NICU).
  
  
  
  Twenty-five infants at least 37 weeks postmenstrual age suspected of aspirating were assessed with FEES and VFSS. Complications, autonomic instability and vital signs before endoscope insertion and following FEES were documented. Blinded video recordings were coded by two reviewers to determine reliability.
  
  
  
  We found no major complications or significant differences between FEES prefeeding and postfeeding vital signs, including respiratory rate, heart rate or oxygen saturation. FEES interrater reliability was 80% for both penetration and aspiration, compared with 87 and 90%, respectively, for VFSS.
  
  
  
  FEES is safe and reliable in assessing laryngeal penetration and tracheal aspiration in NICU infants.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Baylor University Medical Center, Dallas, TX, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Suterwala
authors.affiliation: Department of Physical Medicine, Baylor University Medical Center, Dallas, TX, USA.
authors.forename: J
authors.initials: J
authors.lastname: Reynolds
authors.affiliation: Department of Physical Medicine, Baylor University Medical Center, Dallas, TX, USA.
authors.forename: S
authors.initials: S
authors.lastname: Carroll
authors.affiliation: Department of Physical Medicine, Baylor University Medical Center, Dallas, TX, USA.
authors.forename: C
authors.initials: C
authors.lastname: Sturdivant
authors.affiliation: Department of Communication Sciences and Disorders, Texas Woman's University, Denton, TX, USA.
authors.forename: E S
authors.initials: ES
authors.lastname: Armstrong
mesh_terms: D001696:Biomechanical Phenomena; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005336:Fiber Optic Technology; D005471:Fluoroscopy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D061214:Patient Safety; D010614:Pharynx / Q000503:physiopathology*; D015203:Reproducibility of Results; D053120:Respiratory Aspiration / Q000175:diagnosis*; D013781:Texas; D014741:Video Recording / Q000379:methods