Aspiration Pneunonia

Tests for Aspiration Pneumonia in Children

Aspiration pneumonia is a serious condition that occurs when food, liquid, or other foreign materials are inhaled into the lungs, causing infection. This can be especially concerning in children, as their immune systems are still developing. Among the diagnostic tests, the Barium Swallow Study and Videofluoroscopic Swallow Study (VFSS) are commonly used to evaluate the child’s swallowing function and to determine whether aspiration is occurring.

1. Video fluoroscopic Swallow Study (VFSS)

The Videofluoroscopic Swallow Study (VFSS), also known as a Modified Barium Swallow (MBS), is an advanced diagnostic test that provides a dynamic and real-time view of a child’s swallowing process. During the VFSS, the child consumes barium-infused food or liquid while a fluoroscope (a special type of X-ray machine) records the images. This study allows the physician to observe the entire process of swallowing, from the mouth to the throat and esophagus, and detect if any food or liquid enters the airway (aspiration). An Xray is taken half an hour after ingestion of food to look for reflux of stomach contents into the throat.

Advantages:

Provides real-time, detailed images of the swallowing process.

Can clearly show if aspiration is occurring, and determine the severity.

Allows for a comprehensive assessment of how well the child is managing different textures of food and liquids.

BraiHelps guide treatment options like diet modification, swallowing therapy, or positioning strategies.

Can help diagnose gastroesophageal reflux

Disadvantages:

Requires the child to ingest a variety of foods and liquids, which may be difficult for some children.

Involves radiation exposure, though it is generally considered low and necessary for diagnosis.

2. GER Scan or Nuclear Scintigraphy scan

This is nuclear medicine scan where a child is administered food/milk mixed with a radioactive dye and serial images are taken to look for the presence of dye in the lungs. This test gives information about the gastrictransit time I.e; time taken by food to pass from stomach to the intestines and presence of reflux. This test also helps in detecting any delayed aspiration into the lungs due to gastroesophageal reflux.

Advantages:

Advanced test, more accurate for detecting Gastroesophageal reflux

More comprehensive detection of aspiration pneumonia

Can tell about severity of reflux

Disadvantages:

Exposure to radiation

Child needs to be empty stomach at the start of test for around 4 hours.

When are these Tests Recommended?

Both the Barium Swallow Study and VFSS are recommended when a child exhibits symptoms of aspiration pneumonia, which can include coughing during or after eating, difficulty swallowing, or frequent respiratory infections. They are also used when there is a concern about a child’s ability to swallow safely, especially if there is a history of neurological conditions, developmental delays, or congenital abnormalities.

Frequently Ask Questions

1. What is aspiration pneumonia?

Aspiration pneumonia occurs when food, liquids, or other substances are inhaled into the lungs, leading to infection. It is a serious condition, especially in children, as it can cause respiratory issues and even long-term complications.

2. How do I know if my child has aspiration pneumonia?

Symptoms of aspiration pneumonia include coughing while eating or drinking, difficulty swallowing, fever, changes in breathing patterns, and frequent respiratory infections. If you suspect your child may have aspiration pneumonia, consult a healthcare provider for evaluation.

3. What is the need of these tests?

These tests are indicated in babies with following symptoms
Babies with feeding issues like choking, gagging, vomiting, regurgitation of feeds.
Babies who are not gaining adequate weight.
Babies with recurrent or chronic cough
Babies with airway anomalies

4. Are these tests safe for children?

Both tests involve radiation exposure, but the levels are considered low and are typically safe for children. The benefits of accurately diagnosing aspiration and potential pneumonia generally outweigh the risks.

5. What happens after these tests?

Based on the results of the Barium Swallow Study or VFSS, doctors may recommend specific treatments, such as therapy to improve swallowing function, changes in the child's diet, or positioning strategies to prevent aspiration and reduce the risk of pneumonia.