Silent Aspiration: Results of 1,000 Videofluoroscopic Swallow Evaluations

Garon, Bernard R.; Engle, Molly; Ormiston, Charles

doi:10.1177/154596839601000207

Cited by 61 publications

(81 citation statements)

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“…These data are consistent with the poor inter-and intra-reliability of the BSE in patients suffering from an acute stroke [23]. While the operating characteristics of the BSE have not been studied in recently-extubated survivors of critical illness, several studies of other patient groups have suggested limited diagnostic accuracy when compared to gold standard tests [15,[24][25][26].…”

Section: Discussionsupporting

confidence: 64%

Diagnosis And Treatment Of Post-Extubation Dysphagia: Results From A National Survey

Macht

Wimbish

Clark

et al. 2012

A46. Intensive Care Unit Management and Rapid Response: Provider and Patient Outcomes

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Purpose-This study sought to determine the utilization of speech-language pathologist (SLPs) for the diagnosis and treatment of post-extubation dysphagia in survivors of mechanical ventilation.Methods-We designed, validated, and mailed a survey to 1,966 inpatient SLPs who routinely evaluate patients for post-extubation dysphagia.Results-The majority of SLP diagnostic evaluations (60%; 95% CI = 59-62%) were performed using clinical techniques with uncertain accuracy. Instrumental diagnostic tests (such as fluoroscopy and endoscopy) are more likely to be available at university than community hospitals. After adjusting for hospital size and academic affiliation, instrumental test use varied significantly by geographical region. Treatments for post-extubation dysphagia usually involved dietary adjustment (76%; 95% CI = 73-79%) and postural changes/compensatory maneuvers (86%; 95% CI = 84-88%), rather than on interventions aimed to improve swallowing function (24%; 95% CI = 21-27%).

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Section: Discussionsupporting

confidence: 64%

Diagnosis And Treatment Of Post-Extubation Dysphagia: Results From A National Survey

Macht

Wimbish

Clark

et al. 2012

A46. Intensive Care Unit Management and Rapid Response: Provider and Patient Outcomes

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“…This information is necessary for forming an appropriate and effective treatment plan, which can include swallow therapy and diet recommendations. [396][397][398] There is no consensus in the literature on a preferred instrumental study. Both videofluoroscopy and fiberoptic endoscopic evaluation of swallowing can be used to evaluate the swallow mechanism.…”

Section: Hearing Impairmentsmentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,055

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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“…Patients with silent aspiration are in a higher-risk group for the development of pneumonia or other complications because of the lack of cough reflex reduces patients, family, and hospital staff to detect that aspiration is occurring. 18 Although treatment of dysphagia in cervical spinal cord injury patients is beyond the scope of this article, in case of evident aspiration, conservative measures with regular follow-up evaluation of VFSS or FEES would be feasible, as favorable outcome and natural recovery have been previously reported. 8 In case of liquid aspiration without evident aspiration of semisolids, adjusting food consistencies with the use of food thickener would help, and in case of aspiration in both liquids and semisolids, a temporary alimentation through a Levin tube would be a primary measure.…”

Section: Discussionmentioning

confidence: 98%

Dysphagia in cervical spinal cord injury

et al. 2011

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Results: A total of 121 cervical spinal cord injury patients (106 male and 16 female patients) were included in this study. Ten patients showed evidence of aspiration on VFSS. Statistical correlation to aspiration was found with age, presence of tracheostomy, and symptoms and signs indicating dysphagia. However, out of the 10 patients with evident aspiration, 2 patients did not show any symptoms or signs indicating aspiration. Conclusion: Because of the possibility of silent aspiration, we recommend that physicians treating patients with cervical spinal cord injury should always take the possibility of dysphagia and silent aspiration into consideration, especially in case of previous manifestation of pneumonia, presence of tracheostomy, or presence of signs and symptoms indicating dysphagia.

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Silent Aspiration: Results of 1,000 Videofluoroscopic Swallow Evaluations

Cited by 61 publications

References 0 publications

Diagnosis And Treatment Of Post-Extubation Dysphagia: Results From A National Survey

Diagnosis And Treatment Of Post-Extubation Dysphagia: Results From A National Survey

Guidelines for Adult Stroke Rehabilitation and Recovery

Dysphagia in cervical spinal cord injury

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