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

Abstract

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.

Artificial Intelligence-Based Algorithms and Healthcare Applications of Respiratory Inductance Plethysmography: A Systematic Review

“…The PneuRIP TM technique has been used to successfully evaluate work of breathing (WOB) indices and respiratory patterns and has proven to be effective in recognizing abnormalities in WOB indices and breathing patterns in patients with neuromuscular illnesses. RIP can detect swallowing in both healthy and neurologically affected subjects, which is crucial for identification of choking and subsequent respiratory arrest [32,83]. Difficulty in swallowing associated with neuromuscular pathology has been shown to be detectable with RIP with 95% sensitivity and 99% specificity [83].…”

“…RIP can detect swallowing in both healthy and neurologically affected subjects, which is crucial for identification of choking and subsequent respiratory arrest [32,83]. Difficulty in swallowing associated with neuromuscular pathology has been shown to be detectable with RIP with 95% sensitivity and 99% specificity [83]. Increased intercoastal muscle activity in patients with spinal cord injury at cervical level has been successfully monitored with RIP in comparison with normal subjects, which activity has been undetectable with electromyography (EMG) [84].…”