P2C376: Radiation Exposure from Video Fluoroscopic Swallow Studies in Neonates

Background: Unlike the pediatric population, few studies have described the radiation exposure to neonates from VFSS. Similarly, no study has described the correlation between indication for the study and abnormal findings in neonates. The objective of this study was to determine radiation exposure in neonates from VFSS in a single unit and to determine whether there is any correlation with the indications for performing the study to abnormal findings.

Methods: This study is a retrospective chart review performed after IRB approval. The following data were gathered: gestational age, corrected gestational age at time of first study, highest respiratory rate 24 hours prior to first study, highest FiO2 24 hours prior to first study, indication for the study, results of the studies, and radiation incurred. Binomial data was analyzed using Chi-square test and continuous variables were analyzed using Kruskal-Wallis test. A p-value of < 0.05 was considered significant.

Results: Mean radiation exposure from the VFSS study was equivalent to that of 25 chest radiographs or exposure to 0.84 (SD 0.77) years (7.7 months) of background natural radiation and dose are product (DAP) of 10 (SD 16) uGy*m2. No indication for performing the study was predictive of an abnormal study. Most studies, even if abnormal, prompted no specific intervention or thickening of the feeds.

Conclusion: Radiation exposure from VFSS equaled 25 chest radiographs. Unlike VFSS in children, where specific indications are predictive of abnormal studies, no such relation was seen in our study. VFSS conducted in neonates with tracheoesophageal fistula (TEF) or Pierre Robin Sequence (PRS) were abnormal in all cases. The principle of ALARA (As Low As Reasonably Achievable) demands careful identification of neonates who would benefit from the study.