Influence of the cuff pressure on the swallowing reflex in tracheostomized intensive care unit patients

Abstract

We demonstrated that LaT, EMGp, and ALA of the swallowing reflex were influenced by tracheostomy tube CP. The swallowing reflex was progressively more difficult to elicit with increasing CP and when activated, the resulting motor swallowing activity and efficiency at elevating the larynx were depressed.

A Systematic Review of Tracheostomy Modifications and Swallowing in Adults

“…Of the 10 accepted articles (Table 1), all were prospective case series [39][40][41][42][43][44][45][46][47]. Study sample sizes ranged from 11 [40] to 40 [42] patients and included heterogeneous diagnoses in all but two studies [41,45].…”

“…Of the 10 accepted articles (Table 1), all were prospective case series [39][40][41][42][43][44][45][46][47]. Study sample sizes ranged from 11 [40] to 40 [42] patients and included heterogeneous diagnoses in all but two studies [41,45]. Nine of the included studies [39][40][41][42][43][44][45][46]48] were published in English and one was published in Japanese [47].…”

“…Six studies had portions of their patient sample meeting our inclusion criteria; however, they were excluded following author contact as the pertinent outcomes were not extractable [19,30,33,[36][37][38]. A total of 10 articles were accepted for analysis [39][40][41][42][43][44][45][46][47] (Table 1).…”

Patterns of return to oral intake and decannulation post-tracheostomy across clinical populations in an acute inpatient setting

“…For example, while increasing cuff pressures have been shown to impact swallowing reflexes, subsequent impact on airway protection was not examined or reported (Amathieu et al . ). Furthermore, while some research has suggested aspiration risk to be greater when swallowing with a tracheostomy cuff inflated compared with deflated (Davis et al .…”

“…Whilst methodological differences (i.e., underlying aetiologies, clinical populations, sample sizes, tracheostomy conditions, research design) limit firm conclusions, evidence suggests that while swallowing biomechanics may be altered by changing tracheostomy conditions, there is no change in function. For example, while increasing cuff pressures have been shown to impact swallowing reflexes, subsequent impact on airway protection was not examined or reported (Amathieu et al 2012). Furthermore, while some research has suggested aspiration risk to be greater when swallowing with a tracheostomy cuff inflated compared with deflated (Davis et al 2002, Ding andLogemann 2005), these studies had methodological limitations.…”