Cough response to aspiration in thin and thick fluids during FEES in hospitalized inpatients

International Journal of Language & Communication Disorders
Anna MilesAlexandra Hunting

Abstract

The modifications of fluid viscosity and/or volume are common strategies in dysphagia management, with increased viscosity or reduced volume intended to reduce aspiration. Little attention has been given to whether cough response to aspiration varies across different viscosities and volumes. This prospective observational study investigated aspiration prevalence and cough response to aspiration in thin and thick fluids of two different volumes in patients referred for flexible endoscopic evaluation of swallowing (FEES) in an acute hospital setting. Consecutive inpatients (N = 180) referred for FEES were recruited: stroke 51 (28%); other neurological condition (traumatic brain injury, progressive neurological) 33 (18%); cardiovascular critical care 51 (28%); respiratory illness/condition 23 (13%); spinal injury 9 (5%); and other 13 (7%). A standardized protocol was completed on 268 FEES (180 first FEES, 88 repeat FEES). Penetration-aspiration scale (PAS) scores were obtained for thin and mildly thick fluids at two volumes: 5 ml teaspoon and 50 ml continuous drinking. The incidence of aspiration (PAS > 5) was 32% for thin fluids and 18% for thick fluids. There was a significant association between cough response to aspiration and...Continue Reading

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Citations

Apr 26, 2020·Current Opinion in Otolaryngology & Head and Neck Surgery·Tracy Lazenby-Paterson
Sep 21, 2019·Dysphagia·James C Borders, Danielle Brates
Oct 29, 2020·The Laryngoscope·Frederik J MeisollMartin Ptok
Sep 29, 2021·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Hiroaki MasudaTatsuya Yamasoba
Nov 4, 2021·American Journal of Speech-language Pathology·Phyllis M Palmer, Aaron H Padilla

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