A Retrospective Cohort Study of High-Flow Nasal Cannula Oxygen and Swallowing.

Background: High-flow nasal cannula (HFNC) is an oxygen therapy delivery method used with severely ill patients. The literature regarding the effects of HFNC on overall swallowing function and aspiration risk is limited, and results from current studies are mixed. This study aimed to investigate the...

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Publicado en:Respiratory Care Vol. 70; no. 5; pp. 485 - 492
Autores principales: Ellsworth, Cintamani H., Bartlett, Rebecca S.
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. May2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2025
      vid: 70
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      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        10.1089/respcare.12212
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        atl: A Retrospective Cohort Study of High-Flow Nasal Cannula Oxygen and Swallowing.
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        au:
          Ellsworth, Cintamani H.
          Bartlett, Rebecca S.
        affil: Department of Communication Sciences and Disorders, College of Health and Human Services, Northern Arizona University, Flagstaff Arizona, United States.
      sug:
        subj:
          Nasal Cannula Adverse Effects
          Deglutition Disorders Risk Factors
          Risk Assessment
          Human
          Retrospective Design
          Prospective Studies
          Descriptive Statistics
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Male
          Female
          Data Analysis Software
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background: High-flow nasal cannula (HFNC) is an oxygen therapy delivery method used with severely ill patients. The literature regarding the effects of HFNC on overall swallowing function and aspiration risk is limited, and results from current studies are mixed. This study aimed to investigate the possible association between HFNC and swallowing impairment. Methods: This was a single-center, within-subjects, repeated-measures retrospective study of 21 hospitalized subjects. Participants underwent flexible endoscopic evaluation of swallowing (FEES) while receiving oxygen therapy via HFNC and had another instrumented swallow assessment, a FEES or a modified barium swallow study, when they no longer required HFNC oxygen. Three markers of swallowing function were extracted from reports—aspiration, silent aspiration, and overall swallowing function, and statistical analyses were conducted to assess their relationship to HFNC status. Results: There was a statistically significant difference in the proportion of subjects who aspirated while they were receiving oxygen via HFNC as compared to when they were not on HFNC (P = .033). When on HFNC, 61.9% (13/21) of subjects had an aspiration event during instrumented swallow evaluation; and when off HFNC, 23.8% (5/21) of subjects aspirated. Findings related to silent aspiration during instrumented swallowing evaluation were not significant (P = .32). When subjects were on HFNC, their overall swallowing function was significantly more impaired than when they were off HFNC (P < .001). Conclusions: The results of this study indicate that HFNC is a factor to consider when determining if a patient is appropriate for oral alimentation. Given the limited data on HFNC and swallowing function and the fragility of this population, instrumented examination of swallowing prior to initiation of oral intake may be beneficial. Future prospective studies with larger populations that stratify subjects into risk categories based on subject characteristics and pathophysiology are needed
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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