Ryuji Hori1,2,3, Masaaki Isaka1, Kazuhiko Oonishi2, Toru Yabe4, Yoshitaka Oku3. 1. Department of Physical Therapy, Osaka Yukioka College of Health Science, Ibaragi, Japan. 2. Department of Rehabilitation, Hoshigaoka Medical Center, Hirakata, Japan. 3. Department of Physiology, Hyogo College of Medicine, Nishinomiya, Japan. 4. Murata Manufacturing Co., Ltd., Nagaokakyo, Japan.
Abstract
BACKGROUND AND OBJECTIVE: The purpose of this study was to test the hypothesis that the risk of silent aspiration is increased in non-invasive positive pressure ventilation. METHODS: We analysed the coordination between respiration and swallowing, in 12 young volunteers and 10 elder volunteers, by simultaneously monitoring respiratory flow, laryngeal movement and swallowing sound in three different conditions: control, continuous positive airway pressure (CPAP), and bi-level positive airway pressure (BiPAP). A step-wise multiple regression analysis was performed with the occurrence rate of inspiration after swallows as the dependent variable and various correlated variables as the independent variables. RESULTS: In both subject groups, the occurrence rate of inspiration after swallow was greater with BiPAP compared with control and CPAP conditions. Repetitive saliva swallowing test count and swallow non-inspiratory flow occurrence rate were extracted as predictor variables for risk of inspiration after swallows during BiPAP treatment. CONCLUSION: We found that the occurrence rate of inspiration after swallow is increased with BiPAP use irrespective of age. The results suggest that swallow non-inspiratory flow may trigger inspiratory support in the BiPAP mode, resulting in a risk of aspiration.
BACKGROUND AND OBJECTIVE: The purpose of this study was to test the hypothesis that the risk of silent aspiration is increased in non-invasive positive pressure ventilation. METHODS: We analysed the coordination between respiration and swallowing, in 12 young volunteers and 10 elder volunteers, by simultaneously monitoring respiratory flow, laryngeal movement and swallowing sound in three different conditions: control, continuous positive airway pressure (CPAP), and bi-level positive airway pressure (BiPAP). A step-wise multiple regression analysis was performed with the occurrence rate of inspiration after swallows as the dependent variable and various correlated variables as the independent variables. RESULTS: In both subject groups, the occurrence rate of inspiration after swallow was greater with BiPAP compared with control and CPAP conditions. Repetitive saliva swallowing test count and swallow non-inspiratory flow occurrence rate were extracted as predictor variables for risk of inspiration after swallows during BiPAP treatment. CONCLUSION: We found that the occurrence rate of inspiration after swallow is increased with BiPAP use irrespective of age. The results suggest that swallow non-inspiratory flow may trigger inspiratory support in the BiPAP mode, resulting in a risk of aspiration.
Authors: Steven Talbert; Christine Wargo Detrick; Kimberly Emery; Aurea Middleton; Bassam Abomoelak; Chirajyoti Deb; Devendra I Mehta; Mary Lou Sole Journal: Am J Crit Care Date: 2020-09-01 Impact factor: 2.228
Authors: Eric D McCollum; Tisungane Mvalo; Michelle Eckerle; Andrew G Smith; Davie Kondowe; Don Makonokaya; Dhananjay Vaidya; Veena Billioux; Alfred Chalira; Norman Lufesi; Innocent Mofolo; Mina Hosseinipour Journal: Lancet Respir Med Date: 2019-09-24 Impact factor: 30.700