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Karli Negrin

MS, CCC-SLP

Karli Negrin is an international public speaker and researcher in the areas of cardiac neurodevelopment, cardiac neuroprotection, and cardiac aerodigestive science. Her primary area of research emphasizes preserving the critical relationship of the parent-child dyad for infants born with congenital heart disease. Karli is a leader in her science and is internationally recognized for her work in developmental care in the cardiac intensive care unit. She is employed by Nemours Children's Health, one of the nation's leading surgical cardiac units.
Karli serves as chair of the communications committee of the Cardiac Neurodevelopmental Outcome Collaborative (CNOC). She also serves as vice-chair of the Cardiac Newborn Neuroprotective Network (CNNN). She leads multisite collaborative quality improvement (QI) initiatives dedicated to infant neuroprotection, and she has authored many internationally recognized papers contributing to the science of cardiac feeding practice. She has had the privilege of being invited faculty to speak toward her clinical expertise in multiple arenas, such as the World Congress of Pediatric Cardiology and Cardiac Surgery; the American Speech-Language-Hearing Association; and the Society for Ear, Nose, and Throat Advancement in Children.

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Dysphagia in Children With Congenital Heart Defects

Presented by Hema Desai, MS, CCC-SLP, BCS-S, CLEC, NTMTC and Karli Negrin, MS, CCC-SLP

Dysphagia in Children With Congenital Heart Defects

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Video Runtime: 46 Minutes; Learning Assessment Time: 49 Minutes

Infants and children with congenital heart defects are at high risk for dysphagia due to altered cardiac physiology and developmental delays as well as consequences of surgical intervention and timing. These early challenges can result in persistence of feeding and swallowing difficulties into early childhood, affecting the parent/child relationship and overall development. This intermediate course will benefit clinicians working with this population by helping them understand modifiable and unmodifiable risk factors for dysphagia and how to manage and facilitate improved oral feeding and swallowing development before and after cardiac intervention.

Learning Objectives
  • Identify at least four risk factors for dysphagia in children with CHD
  • Examine two modifiable and two nonmodifiable factors when determining a management plan for oral feeding for children with CHD
  • Apply knowledge of cardiac physiology to understand impact on respiration and ventilation in infants with CHD
  • Implement a feeding plan for an infant with vocal fold injury following cardiac surgery
  • Determine appropriate timing and intensity of feeding therapy depending on the post cardiac intervention course

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Gastrointestinal Problems in Children With CHD: Impact and Management

Presented by Hema Desai, MS, CCC-SLP, BCS-S, CLEC, NTMTC and Karli Negrin, MS, CCC-SLP

Gastrointestinal Problems in Children With CHD: Impact and Management

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Video Runtime: 48 Minutes; Learning Assessment Time: 62 Minutes

Infants and children with congenital heart defects (CHD) are at high risk for gastrointestinal complications due to altered cardiac physiology and timing of surgical intervention. Gastrointestinal difficulties can impact oral feeding development in young children, impacting growth and nutrition. When working with children with CHD who have feeding difficulties, it is important to understand how the GI system can be affected and how dysfunction in this system can result in oral feeding difficulties. This intermediate course will benefit clinicians working with this population by helping them understand various complications of the GI tract and its impact on growth, nutrition, and oral feeding skill development. Management strategies and nutrition considerations will be discussed.

Learning Objectives
  • Compare the timing of three common surgical interventions for infants born with CHD to the approximate developmental feeding milestone
  • Recognize the impact of CHD on gastrointestinal tract function
  • Determine how to decrease risk for necrotizing enterocolitis in an infant with CHD
  • Implement strategies to reduce discomfort associated with reflux for infants with CHD
  • Create a feeding plan to improve feeding tolerance for children with decreased GI motility associated with CHD
  • Implement feeding strategies to decrease feeding refusal associated with chylothorax in infants with CHD
  • Determine goals for feeding therapy for a child with congestive heart failure
  • Examine the consequences of GI complications on nutrition and growth in children with CHD
  • Implement strategies in collaboration with medical providers to decrease feeding tube dependency in children with CHD

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Challenges and Controversies in Feeding Children With Congenital Heart Disease

Presented by Hema Desai, MS, CCC-SLP, BCS-S, CLEC, NTMTC and Karli Negrin, MS, CCC-SLP

Challenges and Controversies in Feeding Children With Congenital Heart Disease

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 63 Minutes; Learning Assessment Time: 43 Minutes

The management of congenital heart disease is a relatively new science and was initially focused on infant survival. There is now a rising concern for the impact of surgical interventions on feeding development. The literature available for dysphagia and feeding management in this specialized population remains scarce in comparison to literature on the neonatal population, lending to controversies in feeding management in infants with congenital heart disease. This intermediate course will benefit clinicians working with this population by analyzing current trends and controversies in dysphagia management in this unique population, identifying research gaps, and describing practice variability in feeding management.

Learning Objectives
  • Compare the timing of three common surgical interventions for infants born with congenital heart disease (CHD) to the approximate developmental feeding milestone
  • Recognize two controversies to application of research in preoperative feeding for infants born with congenital heart defects
  • Analyze three factors in opposing views on feeding infants with CHD on high-flow respiratory support
  • Examine two controversies in the management of dysphagia in infants with vocal fold paresis
  • Analyze three challenges to feeding interventions to support infants with CHD who are experiencing hypermetabolism
  • Examine three controversies in the use of thickened oral liquids for dysphagia management for infants with reduced mesenteric blood flow
  • Analyze three challenges in early breastfeeding introduction for infants born with congenital heart defects
  • Examine three key factors of the social-emotional impact of infant feeding challenges on parental mental health

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