Swallowing and feeding of young children on high-flow oxygen therapy.
Ruhee Hoosain, Bhavani Pillay, Shabnam Abdoola and 2 others
PMID 38572899WHAT IT FOUND
Most young children on high-flow oxygen tolerated pureed and semi-solid foods safely.
Thin liquids triggered coughing and aspiration signs in four children. Chewing was often too tiring. Start with thicker textures and monitor closely, as this small study cannot prove safety for all patients.
Key findings
01Pureed and semi-solid consistencies were tolerated well by all participants who could be assessed, showing normal oral-motor function at both initial and follow-up visits.
02Thin liquids caused signs of penetration or aspiration in 33.3% of participants during the initial assessment, though these risks decreased by the final assessment.
03Solid foods and chewable biscuits were frequently not completed due to the participants' poor medical state or lethargy, rather than oral-motor dysfunction.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was very small (12 children), and the study was exploratory, so findings cannot be generalised. Assessments were clinical and bedside; instrumental evaluation (like videofluoroscopy) was not available to detect silent aspiration. Two participants were excluded from the final assessment due to respiratory decline, which may bias the results toward those who improved. The study did not compare feeding on HFO to feeding without HFO, so it cannot isolate the effect of the oxygen flow on swallowing safety. Participants were from a specific socio-economic context in South Africa, which may affect generalisability to other settings.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that the absence of observed aspiration in this small group means thin liquids are safe for all children on high-flow oxygen. Silent aspiration cannot be ruled out without instrumental assessment, and the study was too small to detect rare but serious adverse events.