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<p>To objectively assess aspiration risk with oral feeding during nasal high-flow (NHF) and to correlate NHF rate and presence and depth (degree) of Oropharyngeal Aspiration (OPA). Cross-sectional study. Single-center, Level III, neonatal unit. Infants born preterm (&lt; 37-weeks gestational age [GA]), aged ≥ 35-weeks to 4-weeks corrected gestational age (CGA) at an oral feeding trial, whilst receiving NHF (&gt; 1&#xa0;L/min), demonstrating oral feeding readiness cues, managing oral secretions, and clinically stable. Participants underwent a clinical feeding evaluation (CFE) and videofluoroscopic swallow study (VFSS). Aspiration status was determined using the Penetration-Aspiration Scale (PAS) on VFSS. Flow rate (L/min), weight-adjusted flow rate (L/kg/min), and fraction of inspired oxygen (FiO<sub>2</sub>) were recorded at CFE and VFSS, with PAS data used for analysis. Twenty preterm infants, (13 males) were recruited. They were born at 24 weeks + 0-days to 36-weeks + 6-days GA, and aged 34-weeks + 6-days to 42-weeks + 5-days CGA at their CFE. One infant had suspected aspiration on CFE, and two had silent aspiration confirmed on VFSS. PAS ranged from 1 to 8 (median 2.00, interquartile range 1.00–2.00). Unadjusted and weight-adjusted flow rates at VFSS were 4–8 (mean±standard deviation 5.60 ± 1.27) L/min and 1.2–3.88 (2.24 <i>±</i> 0.61) L/kg/min, respectively. Level of laryngeal penetration-aspiration was not correlated with flow rate (L/min; <i>p</i> = 0.11) but significantly inversely correlated with weight-adjusted flow rate (L/kg/min; <i>p</i> = 0.01). These early findings suggest that it may be safe to orally feed some clinically stable preterm infants receiving NHF under controlled conditions. Aspiration risk should be based upon patient-specific factors and not just from receiving NHF. However, additional research is needed.</p>

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Oral Feeding and Aspiration Risk in Preterm Infants Receiving Nasal High-Flow Respiratory Support: A Cross-Sectional Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月20日

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  • Kelly A. Weir,
  • Angie Canning,
  • Timothy Hong,
  • Manbir Chauhan,
  • Shane George,
  • Thuy Frakking,
  • Susan Moloney,
  • Rachael Fairhurst,
  • Robert S. Ware,
  • Keith Grimwood

摘要

To objectively assess aspiration risk with oral feeding during nasal high-flow (NHF) and to correlate NHF rate and presence and depth (degree) of Oropharyngeal Aspiration (OPA). Cross-sectional study. Single-center, Level III, neonatal unit. Infants born preterm (< 37-weeks gestational age [GA]), aged ≥ 35-weeks to 4-weeks corrected gestational age (CGA) at an oral feeding trial, whilst receiving NHF (> 1 L/min), demonstrating oral feeding readiness cues, managing oral secretions, and clinically stable. Participants underwent a clinical feeding evaluation (CFE) and videofluoroscopic swallow study (VFSS). Aspiration status was determined using the Penetration-Aspiration Scale (PAS) on VFSS. Flow rate (L/min), weight-adjusted flow rate (L/kg/min), and fraction of inspired oxygen (FiO2) were recorded at CFE and VFSS, with PAS data used for analysis. Twenty preterm infants, (13 males) were recruited. They were born at 24 weeks + 0-days to 36-weeks + 6-days GA, and aged 34-weeks + 6-days to 42-weeks + 5-days CGA at their CFE. One infant had suspected aspiration on CFE, and two had silent aspiration confirmed on VFSS. PAS ranged from 1 to 8 (median 2.00, interquartile range 1.00–2.00). Unadjusted and weight-adjusted flow rates at VFSS were 4–8 (mean±standard deviation 5.60 ± 1.27) L/min and 1.2–3.88 (2.24 ± 0.61) L/kg/min, respectively. Level of laryngeal penetration-aspiration was not correlated with flow rate (L/min; p = 0.11) but significantly inversely correlated with weight-adjusted flow rate (L/kg/min; p = 0.01). These early findings suggest that it may be safe to orally feed some clinically stable preterm infants receiving NHF under controlled conditions. Aspiration risk should be based upon patient-specific factors and not just from receiving NHF. However, additional research is needed.