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Dysphagia (2016) 31:781782 DOI 10.1007/s00455-016-9722-x
http://crossmark.crossref.org/dialog/?doi=10.1007/s00455-016-9722-x&domain=pdf
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Web End = LETTER TO THE EDITOR
FIRST, DO NO HARM: A Response to Oral Alimentationin Neonatal and Adult Populations Requiring High-Flow Oxygen via Nasal Cannula
Pamela Dodrill1 Memorie Gosa2 Suzanne Thoyre3 Catherine Shaker4
Britt Pados3 Jinhee Park5 Nicole DePalma6 Keith Hirst7 Kara Larson8
Jennifer Perez8 Kayla Hernandez8
Received: 12 May 2016 / Accepted: 21 June 2016 / Published online: 19 July 2016 Springer Science+Business Media New York 2016
A recent paper [1] has proposed that the use of respiratory support delivered via high-ow nasal cannula (HFNC) does not have a direct impact on the safety of oral (PO, per os) feeding. As a group of NICU clinicians and researchers, we are writing to express our concern about the design and conclusions presented in this study. Specically, the article does not present sufcient data for the NICU sample studied to support their conclusions in relation to this population (as detailed below). We believe that this could potentially place vulnerable infants at risk of unsafe feeding practices.
Within the NICU environment, HFNC is used as an intervention for many infants with pulmonary disease. Common clinical benets of HFNC support in infants
identied in the literature include a CPAP effect (i.e., delivering positive pressure that stents open the airway), providing anatomic O2 reservoirs in the pharynx and allowing rinsing of pharyngeal dead space [2, 3]. To swallow safely, the bolus needs to be contained in the oral cavity prior to the swallow, and the laryngeal vestibule needs to close (deglutition apnea) as the bolus moves through the pharynx, to...