Intermittent Oroesophageal Tube Feeding via the Airway in Patients With Dysphagia

Shin, Hyo Kyung; Koo, Kyo‐in; Hwang, Chang Ho

doi:10.5535/arm.2016.40.5.794

Cited by 9 publications

(7 citation statements)

References 17 publications

(21 reference statements)

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“…During oral intubation, the posterior pharyngeal and swallowing reflexes and promoted the recovery of swallowing function. Studies have shown that compared with continuous tube feeding, IOE tube feeding could significantly increase the rate of dysphagia function improvement by 5.22 times, increase total serum protein and serum albumin levels of stroke patients with dysphagia, and was more conducive to the conversion of patients to complete oral feeding ( 17 – 19 ). According to the guidelines ( 20 ), we respect the wishes of patients and allow them to participate in treatment decision-making, which may help improve their cooperation and swallowing function.…”

Section: Discussionmentioning

confidence: 99%

Individualized Nutritional Support for Hospitalized Patients With Oropharyngeal Dysphagia After Stroke: A Randomized Controlled Trial

et al. 2022

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ObjectivesPost-stroke dysphagia may cause aspiration pneumonia, malnutrition, dehydration, and other complications. However, data on the effects of nutritional supplementation and its value after stroke are insufficient. We aimed to evaluate the effect of an individualized 1-week nutrition intervention program on swallowing function and nutritional status in stroke patients with oropharyngeal dysphagia.MethodsThis study comprised the control group receiving oral nutritional support and continuous nasogastric tube feeding according to the results of the water swallow test (WST). The intervention group additionally underwent a volume-viscosity swallowing test (V-VST) and intermittent oroesophageal tube feeding based on WST. The outcomes were measured after 7 days of intervention, including the improvement of swallowing function assessment by WST, biochemical parameters, such as total serum protein, serum albumin, hemoglobin levels and body composition. This trial was registered with the Chinese Clinical Trial Registry, identifier ChiCTR 2100054054.ResultsIn total, 173 participants completed the study between September 1, 2020, and April 30, 2021. Patients receiving individualized nutritional support showed a more significant improvement in the total effective rate of swallowing function (95.3% vs. 85.1%, P < 0.05). After the intervention, the total serum protein level (0.97 ± 0.41 vs. −0.83 ± 0.47 g/L; P < 0.05), serum albumin level (0.33 ± 0.28 vs. −1.39 ± 0.36 g/L; P < 0.001) and lean tissue mass (0.13 ± 0.35 vs. −1.00 ± 0.40 g/L; P < 0.05) increased in the intervention group. The decrease of hemoglobin levels in the control group was more evident (−6.17 ± 1.63 vs. −0.64 ± 1.40 g/L; 95%CI, −9.78 to −1.28; P = 0.001). The difference of phase angle between the two groups was statistically significant (5.93 ± 0.88° vs. 5.77 ± 0.78°; P = 0.035), but not in body fat mass.ConclusionsIn stroke patients with oropharyngeal dysphagia, the use of individualized nutritional support based on V-VST and intermittent oroesophageal tube feeding during the first week of hospitalization improved swallowing function and maintained nutritional status.Clinical Trial Registrationhttps://clinicaltrials.gov/, identifier: ChiCTR 2100054054.

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Section: Discussionmentioning

confidence: 99%

Individualized Nutritional Support for Hospitalized Patients With Oropharyngeal Dysphagia After Stroke: A Randomized Controlled Trial

et al. 2022

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“…Blind insertion is related to the risk of aspiration pneumonia in unconscious patients, as the tube may be placed into the larynx or its insertion may cause torsion at the oropharyngeal level 10,33. Shin et al suggested that using the oropharyngeal airway could be helpful during OE tube feeding in patients with dysphagia 5…”

Section: Discussionmentioning

confidence: 99%

“…Acute stroke patients with severe dysphagia usually use compensatory feeding methods such as a nasogastric (NG) tube or parenteral feeding 5,6. NG tube feeding can be a proper alternative enteral feeding method; however, it is inconvenient and sometimes causes complications such as aspiration pneumonia, gastroesophageal reflux, and diarrhea 7.…”

Section: Introductionmentioning

confidence: 99%

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<p>The therapeutic effect and complications of oro-esophageal tube training in stroke patients</p>

Kang

Lee

Park³

et al. 2019

CIA

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Background: Patients with severe dysphagia after stroke are usually fed using a nasogastric tube. However, this method is inconvenient and causes complications. The oro-esophageal (OE) tube has been used as an alternative parenteral feeding method for patients for whom safe oral feeding is impossible. This study aimed to evaluate the therapeutic effects and complications of OE tube feeding in stroke patients with dysphagia. Methods: This study was designed as a retrospective medical chart review of dysphagic stroke patients who were recommended for OE tube feeding. Thirty-eight stroke patients were recommended for OE tube feeding according to videofluoroscopic swallowing study (VFSS) findings. Of those patients, 17 received OE tube feeding training and conventional dysphagia therapy. Follow-up VFSSs were performed sequentially based on the patients’ conditions. When a patient was able to swallow therapeutic foods with specific viscosities during the VFSS, oral feeding was considered to be initiated. Patients were divided into two groups according to final feeding methods. Results: Seventeen patients attempted OE tube feeding. Among them, 64.7% of the patients could change to full oral feeding at their follow-up VFSS evaluation. Additionally, 70.6% of the patients showed gastroesophageal reflux disease regardless of whether they changed to oral feeding. On individual items of the Functional Dysphagia Scale, both groups showed significant improvements in the triggering of pharyngeal swallowing, the amount of residue, and the pharyngeal transit time. These functions were better improved in the patients who could change to oral feeding than in those who could not. Both groups showed significant aggravation of nasal penetration. Conclusion: Our study quantitatively shows the therapeutic effects and complications of OE tube training. OE tube feeding can facilitate the swallowing process and assist patients in transitioning to oral feeding. This easy-to-apply technique may significantly impact future treatment strategies in stroke patients with severe dysphagia.

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“…At the same time, tube-feeding nutrition causes the throat reflex to become passive, thereby producing swallowing difficulties. To reduce these problems, intermittent tube feeding has been employed in the rehabilitation of stroke patients with dysphagia as a nutritional support and dysphagia strategy, [24,25] but its application in PED patients needs further study.…”

Section: Development Of the Ped Predictive Modelmentioning

confidence: 99%

Development and validation of a predictive model for patients with post-extubation dysphagia

Tang¹,

Feng²,

Huang³

et al. 2023

World Journal of Emergency Medicine

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BACKGROUND: Swallowing disorder is a common clinical symptom that can lead to a series of complications, including aspiration, aspiration pneumonia, and malnutrition. This study aimed to investigate risk factors of post-extubation dysphagia (PED) in intensive care unit (ICU) patients with endotracheal intubation, and to develop a risk-predictive model for PED, which could serve as an assessment tool for the prevention and control of PED.METHODS: Patients retrospectively selected from June to December 2021 in a tertiary hospital served as the derivation cohort. Patients recruited from the same hospital from March to June 2022 served as the external validation cohort for the predictive model. We used a combination of variable screening and least absolute shrinkage and selection operator (LASSO) regression to select the most useful candidate predictors and checked the multicollinearity of independent variables using the variance infl ation factor method. Multivariate logistic regression analysis was performed to calculate the odds ratio (OR; 95% confidence interval [95% CI]) and P-value for each variable to predict diagnosis. The screened risk factors were introduced into R software to build a nomogram model. The performance of the model, including discrimination ability, calibration, and clinical benefi t, was evaluated by plotting the receiver operating characteristic (ROC), calibration, and decision curves.RESULTS: A total of 305 patients were included in this study. Among them, 235 patients (53 PED vs. 182 non-PED) were enrolled in the derivation cohort, while 70 patients (17 PED vs. 53 non-PED) were enrolled in the validation cohort. The independent predictors included age, pause of sedatives, level of consciousness, activities of daily living (ADL) score, nasogastric tube, sore throat, and voice disorder. These predictors were used to establish the predictive nomogram model. The model demonstrated good discriminative ability, and the area under the ROC curve (AUC) was 0.945 (95% CI 0.904-0.970). Applying the predictive model to the validation cohort demonstrated good discrimination with an AUC of 0.907 (95% CI 0.831-0.983) and good calibration. The decision-curve analysis of this nomogram showed a net benefi t of the model. CONCLUSION:A predictive model that incorporates age, pause of sedatives, level of consciousness, ADL score, nasogastric tube, sore throat, and voice disorder may have the potential to predict PED in ICU patients.

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Intermittent Oroesophageal Tube Feeding via the Airway in Patients With Dysphagia

Cited by 9 publications

References 17 publications

Individualized Nutritional Support for Hospitalized Patients With Oropharyngeal Dysphagia After Stroke: A Randomized Controlled Trial

Individualized Nutritional Support for Hospitalized Patients With Oropharyngeal Dysphagia After Stroke: A Randomized Controlled Trial

<p>The therapeutic effect and complications of oro-esophageal tube training in stroke patients</p>

Development and validation of a predictive model for patients with post-extubation dysphagia

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