Déglutition et états de conscience altérée

Bicego, Aminata Yasmina; Lejoly, K.; Maudoux, Audrey; Lefèbvre, Philippe; Laureys, Steven; Schweizer, Valérie; Diserens, Karin; Faymonville, Marie-Élisabeth; Vanhaudenhuyse, Audrey

doi:10.1016/j.neurol.2014.04.004

Cited by 10 publications

(6 citation statements)

References 26 publications

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“…The SWADOC was built based upon several existing tools: the Facial Oral Tract Therapy (FOTT) ( 21 , 22 ), the SECONDs ( 10 , 11 ), the New Zealand Secretions Scale (NZSS) ( 23 ), the Oral/Facial Sensitivity subtest of the Comprehensive Assessment Measure for Minimally Responsive Individuals (CAMMRI) ( 24 ), the stimulation method for sensory processing disorder (sensory dysorality) proposed by Senez ( 25 ), and the arousal protocol of the CRS-R ( 8 ). It includes some medical history information from the Food Intake LEVEL Scale (FILS) ( 26 ) and the International Dysphagia Diet Standardization Initiative (IDDSI) ( 27 ).…”

Section: Methods and Analysismentioning

confidence: 99%

“…The SWADOC was inspired by the FOTT ( 22 ), as adapted for patients with DOC in French by Bicego et al ( 21 ), and modified based on our day-to-day clinical experience with patients with DOC. The items assessing command following are based on the SECONDs principles ( 10 , 11 ), insofar as response to verbal command is considered intact if the patient passes a minimum of two out of three trials.…”

Section: Methods and Analysismentioning

confidence: 99%

“…The items assessing command following are based on the SECONDs principles ( 10 , 11 ), insofar as response to verbal command is considered intact if the patient passes a minimum of two out of three trials. The item on quantitative saliva secretions is based on the NZSS ( 21 ), which assesses secretion severity during endoscopy by location, amount (as a percentage), and response. We used the percentages proposed in that scale and adapted them to the oral cavity.…”

Section: Methods and Analysismentioning

confidence: 99%

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The Development and Validation of the SWADOC: A Study Protocol for a Multicenter Prospective Cohort Study

et al. 2021

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Background: After a coma, patients with severe brain injury may present disorders of consciousness (DOC). A substantial proportion of these patients also suffer from severe dysphagia. Assessment of and therapy for swallowing disabilities of patients with DOC are essential because dysphagia has major functional consequences and comorbidities. Dysphagia evaluation in patients with DOC is impeded by the lack of adapted tools. The first aim of this study was to create a new tool, the SWallowing Assessment in Disorders Of Consciousness (SWADOC), and propose a validation protocol. The SWADOC was developed to help therapists assess factors related to swallowing in patients with DOC. The second aim was to investigate the relationship between patients' level of consciousness and SWADOC items and scores.Method/Design: In this multicenter prospective cohort, 104 patients with DOC will be tested three times over five consecutive days with the SWADOC. Statistical analyses will focus on the reliability and validity of the SWADOC, especially the intrarater and interrater reliability, internal consistency, measures of dispersion, and concurrent validity with the Facial Oral Tract Therapy Swallowing Assessment of Saliva (FOTT-SAS). The level of consciousness will be assessed with the Simplified Evaluation of CONsciousness Disorders (SECONDs) and the Coma Recovery Scale-Revised (CRS-R).Discussion: The assessment of swallowing abilities among patients with DOC is the first necessary step toward the development of a customized dysphagia care plan. A validated scoring tool will be essential for clinicians to better assess dysphagia in patients with DOC and document the evolution of their disorders.Trial Registration: NCT04706689.

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Section: Methods and Analysismentioning

confidence: 99%

Section: Methods and Analysismentioning

confidence: 99%

Section: Methods and Analysismentioning

confidence: 99%

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The Development and Validation of the SWADOC: A Study Protocol for a Multicenter Prospective Cohort Study

et al. 2021

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“…Dysphagia itself can lead to airway obstruction, aspiration-pneumonia, dehydration and malnutrition, which may lead to prolonged hospitalization or even death 18 . It is therefore crucial to evaluate dysphagia and coordinated respiratory patterns as early as possible in order to assure better outcome and prevent complications 19 – 21 . In addition, many studies have shown that swallowing initiation can be an early indication of conscious behavior and may provide evidence of conscious awareness in DOC patients 22 – 24 .…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, clinical assessments are only 66% accurate in detecting aspiration 30 . It is therefore necessary to complement this rating with an objective examination of swallowing 21 .…”

Section: Introductionmentioning

confidence: 99%

Feasibility study of the Nox-T3 device to detect swallowing and respiration pattern in neurologically impaired patients in the acute phase

Theytaz

Vuistiner

Schweizer

et al. 2023

Sci Rep

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Dysphagia is a frequent complication in neurologically impaired patients, which can lead to aspiration pneumonia and thus prolonged hospitalization or even death. It is essential therefore, to detect and assess dysphagia early for best patient care. Fiberoptic endoscopic and Videofluoroscopy evaluation of swallowing are the gold standard exams in swallowing studies but neither are perfectly suitable for patients with disorders of consciousness (DOC). In this study, we aimed to find the sensitivity and specificity of the Nox-T3 sleep monitor for detection of swallowing. A combination of submental and peri-laryngeal surface electromyography, nasal cannulas and respiratory inductance plethysmography belts connected to Nox-T 3 allows recording swallowing events and their coordination with breathing, providing time-coordinated patterns of muscular and respiratory activity. We compared Nox-T3 swallowing capture to manual swallowing detection on fourteen DOC patients. The Nox-T3 method identified swallow events with a sensitivity of 95% and a specificity of 99%. In addition, Nox-T3 has qualitative contributions, such as visualization of the swallowing apnea in the respiratory cycle which provide additional information on the swallowing act that is useful to clinicians in the management and rehabilitation of the patient. These results suggest that Nox-T3 could be used for swallowing detection in DOC patients and support its continued clinical use for swallowing disorder investigation.

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