Multidisciplinary approach to paediatric Aerodigestive Disorders: A single centre longitudinal observational study

Abstract

Introduction: Aerodigestive clinics (ADC) provide multidisciplinary care to children with complex congenital or acquired conditions affecting breathing, swallowing, and growth. Our objective was to describe the demographic, clinical, etiological & investigational profile of children attending the inaugural ADC in Queensland. Methods: Children referred to the ADC at Queensland Children's Hospital from August 2018 to December 2019 were included. Data on clinical, growth & lung function parameters, bronchoscopy & endoscopy findings, thoracic imaging, and co-morbidities were retrospectively analysed. Results: 56 children [median(range) age 4 years(3m-15years);18F] attended the ADC over 15 months. 48(86%) children had previous tracheoesophageal fistula with oesophageal atresia, 3(5%) had congenital diaphragmatic hernia, 3(5%) had congenital pulmonary malformation and 1(2%) child had isolated oesophageal atresia. 21(38%) also had a VACTERL/VATER association. Growth was adequate (mean weight & BMI Z score -0.63 & -0.48 respectively). 34(61%) reported ongoing wet cough with 12(21%) requiring previous hospital admission for respiratory tract infection. 14(25%) children had bronchiectasis, 33(59%) had clinical tracheomalacia with 23 confirmed on bronchoscopy. Dysphagia was reported in 15(27%) children with 11(20%) being gastrostomy fed; 5(9%) had biopsy proven eosinophilic oesophagitis. 35(63%) children were on gastric-acid suppressants and 9(16%) on macrolide therapy. Conclusion: This is the first description of a paediatric ADC from the southern hemisphere. Ongoing respiratory morbidity was common. Potential benefits of this model of care need to be studied prospectively.L6338037632021-01-05 <br />