Improved Respiratory Outcomes Following Multidisciplinary Aerodigestive Care in Medically Complex Children: A Longitudinal Single-Center Study.

Introduction: Children with medical complexity are at risk of pulmonary injury due to chronic pulmonary aspiration. Our study aimed to determine the effect of multidisciplinary evaluation and periodic follow-up of aerodigestive disorders on the final status of the respiratory conditions.

Materials and methods: Children followed for at least 1 year by the Medipol University Aerodigestive Clinic between March 2019 and August 2024 were included. Demographic data, underlying diagnoses, respiratory and nutritional status at admission, hospitalization frequency and duration, and home ventilation requirements were analyzed. Swallowing dysfunction and/or aspiration were assessed using clinical and instrumental methods. All children received tailored swallowing and nutritional therapy.

Results: Of 89 children, 72 of them were followed for at least 1 year (12 died, 5 lost follow-up). The median follow-up period was 30 months (18-46 months). The median age during that time of admission was 30 months (11-62 months). The most common underlying conditions were neuromuscular disorders (43%), bronchopulmonary dysplasia (14%), and congenital heart disease (13%). Dysphagia was confirmed instrumentally in 61% of patients. Among tracheostomized children, 13 of 22 (60%) were successfully decannulated. Respiratory support was reduced or discontinued in 14 of 31 (45%) children. Oral feeding was achieved in 21 (29%) previously tube-fed children. Hospitalizations decreased in all but one child, and 45 (62.5%) required no hospitalization in the year following aerodigestive clinic evaluation.

Conclusions: A multidisciplinary aerodigestive approach improves respiratory outcomes in children with medical complexity by reducing the need for respiratory support, facilitating decannulation, and decreasing hospitalizations.