Original Article The prevalence and effects of aspiration among neonates at the time of discharge Emily Karsch, 1 Sharon Y. Irving, 1,2 Brandon S. Aylward, 3 William T. Mahle 3 1 School of Nursing, University of Pennsylvania; 2 Department of Nursing, Respiratory Care and Neurodiagnostic Services, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; 3 Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, United States of America Abstract Background: Neonates undergoing heart surgery for CHD are at risk for postoperative gastrointestinal complications and aspiration events. There are limited data regarding the prevalence of aspiration after neonatal cardiothoracic surgery; thus, the effects of aspiration events on this patient population are not well understood. This retrospective chart review examined the prevalence and effects of aspiration among neonates who had undergone cardiac surgery at the time of their discharge. Introduction: This study examined the prevalence of aspiration among neonates who had undergone cardiac surgery. Demographic data regarding these patients were analysed in order to determine risk factors for postoperative aspiration. Post-discharge feeding routes and therapeutic interventions were extracted to examine the time spent using alternate feeding routes because of aspiration risk or poor caloric intake. Modified barium swallow study results were used to evaluate the effectiveness of the test as a diagnostic tool. Materials and methods: A retrospective study was undertaken of neonates who had undergone heart surgery from July, 2013 to January, 2014. Data describing patient demographics, feeding methods, and follow-up visits were recorded and compared using a χ 2 test for goodness of fit and a Kaplan–Meier graph. Results: The patient population included 62 infants – 36 of whom were male, and 10 who were born with single-ventricle circulation. The median age at surgery was 6 days (interquartile range = 4 to 10 days). Modified barium swallow study results showed that 46% of patients (n = 29) aspirated or were at risk for aspiration, as indicated by laryngeal penetration. In addition, 48% (n = 10) of subjects with a negative barium swallow or no swallow study demonstrated clinical aspiration events. Tube feedings were required by 66% (n = 41) of the participants. The median time spent on tube feeds, whether in combination with oral feeds or exclusive use of a nasogastric or gastric tube, was 54 days; 44% (n = 27) of patients received tube feedings for more than 120 days. Premature infants were significantly more likely to have aspiration events than infants delivered at full gestational age (OR p = 0.002). Infants with single-ventricle circulation spent a longer time on tube feeds (median = 95 days) than infants with two-ventricle defects (median = 44 days); the type of cardiac defect was independent of prevalence of an aspiration event. Conclusions: Aspiration is common following neonatal cardiac surgery. The modified barium swallow study is often used to identify aspiration events and to determine an infant’s risk for aspirating. This leads to a high proportion of infants who require tube feedings following neonatal cardiac surgery. Keywords: Aspiration; neonate; cardiothoracic surgery; modified barium swallow study; tube feeds; CHD Received: 28 July 2016; Accepted: 11 December 2016 Correspondence to: W. T. Mahle, MD, Children’s Healthcare of Atlanta, Emory University School of Medicine, 1405 Clifton Road NE, Atlanta, GA 30322-1062, United States of America. Tel: +404 785 1672; Fax: 404 785 6021; E-mail: wmahle@emory.edu Cardiology in the Young 2017; Page 1 of 7 © Cambridge University Press, 2017 doi:10.1017/S104795111600278X https://doi.org/10.1017/S104795111600278X Downloaded from https:/www.cambridge.org/core. Driscoll Childrens Hospital, on 13 Feb 2017 at 16:24:18, subject to the Cambridge Core terms of use, available at https:/www.cambridge.org/core/terms.