@Article{chd.12636,
AUTHOR = {Jennifer P. Lundine, Robert Dempster, Kirby Carpenito, Holly Miller‐Tate, Wendelin Burdo‐Hartman, Elizabeth Halpin, Omar Khalid},
TITLE = {Incidence of aspiration in infants with single‐ventricle  physiology following hybrid procedure},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {13},
YEAR = {2018},
NUMBER = {5},
PAGES = {706--712},
URL = {http://www.techscience.com/schd/v13n5/39049},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b>  Swallowing dysfunction is a known complication for infants with complex congenital heart disease (CHD), but few studies have examined swallowing outcomes following the hybrid procedure for stage 1 palliation in children with single 
ventricle physiology.<br/>
<b>Objectives:</b>  (1) Identify the incidence of aspiration in all infants with single ventricle 
physiology who underwent the hybrid procedure and (2) Compare results of clinical 
bedside and instrumental swallowing evaluations to examine the predictive value of 
a less invasive swallowing assessment for this population of high‐risk infants.<br/>
<b>Methods:</b>  This was a retrospective cohort chart review study. All patients with single‐ventricle physiology who underwent the hybrid procedure received a referral for 
subsequent instrumental swallow assessment during a 4‐year period. Results from 
clinical bedside evaluations were compared to those of the instrumental 
assessment.<br/>
<b>Results:</b>  Fifty infants were included in this study. During instrumental swallow assessment, aspiration was observed in 28% of infants following the hybrid procedure. 
Normal swallowing function was identified in 44% of infants, and 28% demonstrated 
laryngeal penetration. Neither length of intubation nor prematurity were found to be 
predictors of aspiration. Thirty‐six of these infants were assessed via clinical bedside 
evaluation prior to the instrumental evaluation. The sensitivity of the clinical bedside 
evaluation was 0.73 and the specificity was 0.92.<br/>
<b>Conclusions:</b> This study reports on a cohort of infants with single ventricle physiology following the hybrid procedure and found the incidence of aspiration to be lower 
than previously reported. Improved clinical bedside evaluation guidelines are needed 
so that clinicians can predict more reliably which infants are at risk for aspiration following the hybrid procedure.},
DOI = {10.1111/chd.12636}
}