Silent aspiration in patients with exacerbation of COPD

Abstract

Patients with chronic obstructive pulmonary disease (COPD) are susceptible to aspiration, probably due to discoordination between breathing and swallowing, cricopharyngeal muscle dysfunction, and changes in lung volume [1,2]. TERADA et al.[3] found a significantly higher prevalence of an abnormal swallowing reflex in patients with COPD than in healthy controls. SHAKER et al. [4] found that patients with acute exacerbation of COPD (AECOPD) have a higher risk of aspiration. In this cross-sectional study, using the technetium-99m-sulfur colloid ( 99m Tc-SC) salivary scintigraphy method that is believed to be more sensitive than techniques using in previous studies, the prevalence and risk factors of silent aspiration in hospitalised AECOPD patients was studied.In this study, hospitalised AECOPD patients were recruited from the Guangzhou Institute of Respiratory Disease, First Affiliated

Effects of exercise‐induced dyspnoea on the aspiration rate among patients with acute exacerbation of chronic obstructive pulmonary disease

“…Moreover, aspiration was significantly correlated with the number of one‐year episodes of the AECOPD. The dyspnoea index was identified as the risk factor for COPD …”

“…Images were collected from the oropharynx to the lower stomach edge. Dynamic images were obtained at 30‐seconds intervals for a total of 30 minutes, followed by 5 minutes of static image collection (posterior and anterior) …”

“…If the radionuclide was present in the trachea and bronchi, the diagnosis was positive for aspiration (Figure ). Otherwise, the diagnosis was considered aspiration negative (Figure ) …”

“…Dynamic images were obtained at 30-seconds intervals for a total of 30 minutes, followed by 5 minutes of static image collection (posterior and anterior). 2 AECOPD patients were considered negative if both dynamic and static posterior and anterior images showed the radionuclide solution entered the stomach via the mouthoesophagus route, and was not observed in the left or right bronchi and lungs when in the supine position. If patients were negative, nasopharyngeal infusion of the radionuclide at 24 mL/h would continue.…”

“…Such as, LR exercise might aggravate the patient's dyspnoea and increase respiratory rate. Results from our preliminary study suggested that aspiration rates reached 33.3% among patients recovering from acute exacerbation of COPD, and the dyspnoea index was a high risk factor for aspiration. Shaker et al also reported that AECOPD patients tend to have aspiration rates due to increased respiratory frequency.…”