The Influence of Airflow Via High-Flow Nasal Cannula on Duration of Laryngeal Vestibule Closure

Allen, Katie; Galek, Kristine

doi:10.1007/s00455-020-10193-0

Cited by 16 publications

(49 citation statements)

References 60 publications

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“…Aspiration was not visualized, and increasing airflow was associated with increasing laryngeal vestibule closure. Although no association was objectively observed between penetration/aspiration at any flow rate, participants reported subjective complaints of increased difficulty swallowing at higher flow rates [35]. In another study with healthy volunteers, a flow rate > 40 L/min was associated with decreased swallowing function [36].…”

Section: Nutrition Via Oral Route In Patients With High-flow Nasal Cannulamentioning

confidence: 94%

Nutrition Therapy in Non-intubated Patients with Acute Respiratory Failure

et al. 2021

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Purpose of Review A challenging aspect of the care for patients with acute respiratory failure is their nutrition management. This manuscript consists of a literature review on nutrition therapy in non-intubated patients with acute respiratory failure receiving high-flow nasal cannula oxygenation or non-invasive positive pressure ventilation. Recent Findings Studies show that non-intubated patients with acute respiratory failure either on non-invasive ventilation or high-flow nasal cannula are largely underfed in the initial phase of their hospitalization. Although data is limited, the available evidence suggests the feasibility of initiating oral diet in the majority of these patients in the early phase. Summary Initial evaluation includes mental status evaluation, the Yale swallowing screening protocol, and an assessment of severity of illness. The goal should be to initiate oral diet within 24 h. If patient cannot initiate oral diet, the reason for not initiating oral diet should dictate the next step. For instance, if the reason is failure of the swallow screening, further evaluation with fiberoptic endoscopy is warranted. The inability to provide oral diet for a patient in respiratory distress may a harbinger of failure of non-invasive oxygen therapy and should prompt consideration for endotracheal intubation. We suggest placement of a small-bore feeding tube for enteral nutrition if patient is unable receive oral diet after 48 h. Conclusions The nutrition management of these patients is better provided by a multidisciplinary team in a protocolized manner.

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Section: Nutrition Via Oral Route In Patients With High-flow Nasal Cannulamentioning

confidence: 94%

Nutrition Therapy in Non-intubated Patients with Acute Respiratory Failure

et al. 2021

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“…However, prolonged apnea tolerance allows the laryngeal closure structure to remain closed until the end of swallowing, and aspiration is considered to have improved. This hypothesis may be supported by the fact that previous studies in healthy individuals have shown that HFNC oxygen therapy prolongs the laryngeal vestibule closure time during swallowing with increased oxygen flow [15] . Second, HFNC oxygen therapy may have improved the timing of swallowing.…”

Section: Discussionmentioning

confidence: 85%

High-flow nasal cannula oxygen therapy was effective for dysphagia associated with respiratory muscle paralysis due to cervical spinal cord injury

Watanabe¹,

Tamura

Imai³

et al. 2021

Medicine

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Rationale:Respiratory muscle paralysis due to low cervical spinal cord injury (CSCI) can lead to dysphagia. Noninvasive positive airway pressure (PAP) therapy can effectively treat this type of dysphagia. High-flow nasal cannula (HFNC) oxygen therapy can generate a low level of positive airway pressure resembling PAP therapy, it may improve the dysphagia.Patient concerns:The patient was an 87-year-old man without preexisting dysphagia. He suffered a CSCI due to a dislocated C5/6 fracture, without brain injury, and underwent emergency surgery. Postoperatively (day 2), he complained of dysphagia, and the intervention was initiated.Diagnosis:Based on clinical findings, dysphagia in this case, may have arisen due to impaired coordination between breathing and swallowing, which typically occurs in patients with CSCI who have reduced forced vital capacity.Interventions:HFNC oxygen therapy was started immediately after the surgery, and swallowing rehabilitation was started on Day 2. Indirect therapy (without food) and direct therapy (with food) were applied in stages. HFNC oxygen therapy appeared to be effective because swallowing function temporarily decreased when the HFNC oxygen therapy was changed to nasal canula oxygen therapy.Outcomes:Swallowing function of the patient improved and he did not develop aspiration pneumonia.Lessons:HFNC oxygen therapy improved swallowing function in a patient with dysphagia associated with respiratory-muscle paralysis following a CSCI. It may have prolonged the apnea tolerance time during swallowing and may have improved the timing of swallowing. HFNC oxygen therapy can facilitate both indirect and direct early swallowing therapy to restore both swallowing and respiratory function.

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“…Stimulation of receptors in the upper airway (soft palate, uvula, hard palate, faucial pillars, pharynx, and epiglottis) can initiate the swallowing reflex (Nishino, 2013;Nishino et al, 1989), so water infusion and light touch of catheter may have activated these receptors. Subsequent studies discussed later in this review (Allen & Galek, 2020;Flores et al, 2019) have also suggested that healthy adults may have the ability to cognitively engage and compensate to protect the airway when higher flow rates were deployed via HFNC.…”

Section: Discussion and Considerationsmentioning

confidence: 93%

“…This prospective design investigated the influence of airflow (LPM) delivered via HFNC on duration of laryngeal vestibule closure (dLVC) and described airway invasion during various LPM deliveries (Allen & Galek, 2020). Twenty-nine healthy adults were included.…”

Section: Methodsmentioning

confidence: 99%

Effects of Oxygen via High-Flow Nasal Cannula on Adult Oropharyngeal Swallowing: A Literature Review

Devlin

O'Bryan

2021

Perspect ASHA SIGs

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Purpose The use of high-flow oxygen via nasal cannula has become increasingly more common in various patient populations given the multiple benefits for treating respiratory distress and failure. There is emerging, though varying research on the impact high-flow oxygen delivery may have on adult oropharyngeal swallowing function. The purpose of this literature review is to outline available research and examine study design, populations investigated, findings, and clinical considerations of these findings. Method After an extensive online database search, we found five available peer-reviewed research articles specifically investigating oropharyngeal swallowing function in adults receiving high-flow nasal cannula (HFNC) therapy. Each article was reviewed and summarized in detail with close attention paid to results and clinical implications. Limitations, indirectness, and/or methodologic flaws are highlighted for the readers' consideration. Conclusions Four prospective design studies and one retrospective data analysis collection have been published evaluating the effects of high-flow oxygen therapy on adult oropharyngeal swallowing. Three of the prospective design studies evaluated healthy adults; one prospective design and the retrospective analysis data collection investigated acute care patients requiring HFNC. Study findings varied greatly likely due to variability of each study's subject population, design, and methods. Variability of results may make it challenging for speech pathologists attempting to use evidence-based decision making in clinical practice. Additional studies investigating nonhealthy subjects undergoing instrumental swallow studies while on HFNC are warranted.

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The Influence of Airflow Via High-Flow Nasal Cannula on Duration of Laryngeal Vestibule Closure

Cited by 16 publications

References 60 publications

Nutrition Therapy in Non-intubated Patients with Acute Respiratory Failure

Nutrition Therapy in Non-intubated Patients with Acute Respiratory Failure

High-flow nasal cannula oxygen therapy was effective for dysphagia associated with respiratory muscle paralysis due to cervical spinal cord injury

Effects of Oxygen via High-Flow Nasal Cannula on Adult Oropharyngeal Swallowing: A Literature Review

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