Dysphagie bei tracheotomierten Patienten nach Langzeitbeatmung

Heidler, Maria-Dorothea

doi:10.1055/a-0769-6551

Cited by 2 publications

(3 citation statements)

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“…After tracheostomy, a significant and persistent expiratory airflow leak occurs, which might counteract the protective effect of expiration on the upper airway, resulting in unsafe swallowing, and possible aspiration (Eibling and Gross, 1996). The decrease in subglottic pressure after tracheostomy severely affects the normal respiratoryswallowing coordination model (Gross, 2009;Fernandez-Carmona et al, 2012;Heidler, 2019b). Previous research has shown that PMV can improve verbal communication and swallowing, especially in the swallowing-breathing coordination model (Prigent et al, 2012;Adam et al, 2015;Fröhlich et al, 2017).…”

Section: Speculation On the Underlying Mechanism Of Aspiration Preven...mentioning

confidence: 99%

“…Tracheostomy after ABI is associated with a series of pathological changes in the biomechanics of the upper respiratory tract, pharynx, and esophagus (Fernandez-Carmona et al, 2012). In particular, the reduction of glottic airflow after tracheostomy results in a corresponding inability to increase subglottic pressure during swallowing; as a result, normal respiratory-swallowing coordination is impaired, increasing the risk of aspiration (Fernandez-Carmona et al, 2012;Heidler, 2019b). Subglottic pressure is defined as the pressure measured when the vocal cords are adducted, and has been proved to be closely associated with swallowing function in tracheostomized patients (Petekkaya et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical mechanism of reduced aspiration by the Passy-Muir valve in tracheostomized patients following acquired brain injury: Evidences from subglottic pressure

Han

Meng

et al. 2022

Front. Neurosci.

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ObjectiveAspiration is a common complication after tracheostomy in patients with acquired brain injury (ABI), resulting from impaired swallowing function, and which may lead to aspiration pneumonia. The Passy-Muir Tracheostomy and Ventilator Swallowing and Speaking Valve (PMV) has been used to enable voice and reduce aspiration; however, its mechanism is unclear. This study aimed to investigate the mechanisms underlying the beneficial effects of PMV intervention on the prevention of aspiration.MethodsA randomized, single-blinded, controlled study was designed in which 20 tracheostomized patients with aspiration following ABI were recruited and randomized into the PMV intervention and non-PMV intervention groups. Before and after the intervention, swallowing biomechanical characteristics were examined using video fluoroscopic swallowing study (VFSS) and high-resolution manometry (HRM). A three-dimensional (3D) upper airway anatomical reconstruction was made based on computed tomography scan data, followed by computational fluid dynamics (CFD) simulation analysis to detect subglottic pressure.ResultsThe results showed that compared with the non-PMV intervention group, the velopharynx maximal pressure (VP-Max) and upper esophageal sphincter relaxation duration (UES-RD) increased significantly (P < 0.05), while the Penetration-Aspiration Scale (PAS) score decreased in the PMV intervention group (P < 0.05). Additionally, the subglottic pressure was successfully detected by CFD simulation analysis, and increased significantly after 2 weeks in the PMV intervention group compared to the non-PMV intervention group (P < 0.001), indicating that the subglottic pressure could be remodeled through PMV intervention.ConclusionOur findings demonstrated that PMV could improve VP-Max, UES-RD, and reduce aspiration in tracheostomized patients, and the putative mechanism may involve the subglottic pressure.Clinical trial registration[http://www.chictr.org.cn], identifier [ChiCTR1800018686].

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Section: Speculation On the Underlying Mechanism Of Aspiration Preven...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biomechanical mechanism of reduced aspiration by the Passy-Muir valve in tracheostomized patients following acquired brain injury: Evidences from subglottic pressure

Han

Meng

et al. 2022

Front. Neurosci.

View full text Add to dashboard Cite

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“…In many cases, tracheostomy is only performed after 30 days of intubation, which is otherwise not commonly done. Therefore, individuals who undergo orotracheal intubation and postextubation tracheostomy may present dysphagia, which justifies conducting research on swallowing disorders among this population (Zareifopoulos et al, 2020;Heidler, 2019;Friche et al, 2019;Gharib et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

The prevalence of dysphagia and changes in the quality of swallowing in patients infected with COVID-19

Santos¹,

Figueiredo

Nunes

et al. 2022

RSD

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Introduction: The emergence of COVID-19 has given rise to research on possible consequences on swallowing and on the quality of swallowing in individuals who were infected by SARS-CoV2. Pulmonary infections, the need for orotracheal intubation, tracheostomy, symptoms, comorbidities, and other factors caused uncertainties about the interference of these factors in the function of swallowing and in quality of life. Objective: To verify the association between the prevalence of swallowing disorders and the quality of life of patients with possible risk factors infected with COVID-19. Methods: This is an observational, analytical, cross-sectional, quantitative study. It was carried out from August to September 2020, in a Hospital in Brasília – DF, with patients hospitalized due to COVID-19 infection. 90 individuals participated in this study; they were adults and elderly with a mean age of 59.9 ± 16.09. Among participants, 55 were men (61.1%) and 35 were women (38.9%) who had a history of swallowing disorders. Data were collected through the analysis of patients' medical records, application of the EAT-10 Test, and the Quality of Life in Swallowing Disorders (SWAL-QOL) validated for Brazilian Portuguese. Results: Considering the scores obtained by the EAT-10 questionnaire, the analysis showed a statistical significance for the variables senescence and tracheostomy (p < 0.05). The analysis of the SWAL-QOL test was performed by domains and showed a statistical significance between the variables senescence, tracheostomy, ageusia, anosmia, and hyporexia. Conclusion: Elderly people infected with COVID-19 and in need of tracheostomy have a greater chance of dysphagia. In addition, factors such as senescence, tracheostomy, age and hyporexia can improve the quality of swallowing in these patients.

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Dysphagie bei tracheotomierten Patienten nach Langzeitbeatmung

Cited by 2 publications

References 20 publications

Biomechanical mechanism of reduced aspiration by the Passy-Muir valve in tracheostomized patients following acquired brain injury: Evidences from subglottic pressure

Biomechanical mechanism of reduced aspiration by the Passy-Muir valve in tracheostomized patients following acquired brain injury: Evidences from subglottic pressure

The prevalence of dysphagia and changes in the quality of swallowing in patients infected with COVID-19

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