Pharyngeal electrical stimulation for early decannulation in tracheotomised patients with neurogenic dysphagia after stroke (PHAST-TRAC): a prospective, single-blinded, randomised trial

Lancet Neurology
Rainer DziewasPHAST-TRAC Investigators

Abstract

Dysphagia after stroke is common, especially in severely affected patients who have had a tracheotomy. In a pilot trial, pharyngeal electrical stimulation (PES) improved swallowing function in this group of patients. We aimed to replicate and extend this single-centre experience. We did a prospective, single-blind, randomised controlled trial across nine sites (seven acute care hospitals, two rehabilitation facilities) in Germany, Austria, and Italy. Patients with recent stroke who required tracheotomy were randomly assigned to receive 3 days of either PES or sham treatment (1:1). All patients had the stimulation catheter inserted; sham treatment was applied by connecting the PES base station to a simulator box instead of the catheter. Randomisation was done via a computerised interactive system (stratified by site) in blocks of four patients per site. Patients and investigators applying PES were not masked. The primary endpoint was assessed by a separate investigator at each site who was masked to treatment assignment. The primary outcome was readiness for decannulation 24-72 h after treatment, assessed using fibreoptic endoscopic evaluation of swallowing and based on a standardised protocol, including absence of massive pooli...Continue Reading

Citations

Jul 10, 2019·Stroke; a Journal of Cerebral Circulation·Sonja Suntrup-KruegerRainer Dziewas
May 26, 2020·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Christopher CabibOmar Ortega
Jul 23, 2020·Intensive Care Medicine·Patrick ZuercherJoerg C Schefold
Nov 10, 2018·Der Nervenarzt·Julian Bösel
Jul 28, 2019·Intensive Care Medicine·M SmithG Citerio
Jan 31, 2020·Intensive Care Medicine·Patrick ZuercherJoerg C Schefold
Jun 10, 2020·Intensive Care Medicine·Sallyanne DuncanBronagh Blackwood
Mar 30, 2019·Critical Care : the Official Journal of the Critical Care Forum·Patrick ZuercherJoerg C Schefold
Sep 3, 2020·Pathogens·Pengxu WeiYubo Fan
Mar 8, 2019·Neurotoxicity Research·Marvin N PeterGerrit Paasche
Mar 11, 2020·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Aisling McFallTerence J Quinn
Nov 3, 2020·Current Neurology and Neuroscience Reports·Corinne A JonesMing-Chieh Ding
Dec 11, 2020·Neuromodulation : Journal of the International Neuromodulation Society·Ivy ChengShaheen Hamdy
Jan 16, 2021·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Sonja Suntrup-KruegerRainer Dziewas
May 5, 2021·Neurological Research and Practice·Rainer DziewasChristina Pflug
May 26, 2021·Scientific Reports·Tobias BraunMartin Juenemann
Jun 8, 2021·Journal of the Intensive Care Society·Jackie McRaeEibhlin Cleary

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