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Swallowing function during high-flow nasal cannula therapy

Masaki Oomagari, Ichiro Fujishima, Norimasa Katagiri, Shinichi Arizono, Koji Watanabe, Tomohisa Ohno, Hiroshi Maeda, Motoki Moriwaki, Mariko Fujimori, Shohei Ohgi
European Respiratory Journal 2015 46: PA4199; DOI: 10.1183/13993003.congress-2015.PA4199
Masaki Oomagari
1Department of Rehabilitation Medicine, Seirei Mikatahara General Hospital, Hamamatsu, Japan
3School of Health Sciences, Seirei Christopher University, Hamamatsu, Japan
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Ichiro Fujishima
2Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
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Norimasa Katagiri
1Department of Rehabilitation Medicine, Seirei Mikatahara General Hospital, Hamamatsu, Japan
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Shinichi Arizono
3School of Health Sciences, Seirei Christopher University, Hamamatsu, Japan
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Koji Watanabe
4Department of Rehabilitation Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
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Tomohisa Ohno
5Department for Advanced Dental Research Center of Advanced Medicine for Dental and Oral Diseases, Japanese National Center for Geriatrics and Gerontology, Obu, Japan
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Hiroshi Maeda
1Department of Rehabilitation Medicine, Seirei Mikatahara General Hospital, Hamamatsu, Japan
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Motoki Moriwaki
1Department of Rehabilitation Medicine, Seirei Mikatahara General Hospital, Hamamatsu, Japan
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Mariko Fujimori
6Department of Nursing, Seirei Mikatahara General Hospital, Hamamatsu, Japan
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Shohei Ohgi
3School of Health Sciences, Seirei Christopher University, Hamamatsu, Japan
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Abstract

Background and Objective: High-flow nasal cannula therapy is used as a noninvasive treatment for respiratory disease. The safety of swallowing during the high-flow nasal cannula therapy has not been reported. The purpose of this study was to assess the effect of high-flow nasal cannula therapy on swallowing function.

Methods: Thirty-two healthy subjects underwent high-flow nasal cannula therapy at different flow rates chosen at random (0, 10, 20, 30, 40, and 50 L/min). All subjects underwent the 30-mL water swallow test (WST) and the repetitive saliva swallowing test (RSST) during use of the high-flow nasal cannula. Difficulty swallowing water during the WST was evaluated using a visual analog scale. The swallowing time and number of swallows in 30 seconds were evaluated during the RSST.

Results: In the WST, five subjects (15.6%) choked at flow rates of 40 and 50 L/min (p < 0.05). A flow rate of > 20 L/min was lower number of swallows during the RSST and greater difficulty swallowing than a flow rate of 0 L/min (p < 0.05). The change in the swallowing time was significantly associated with difficulty swallowing at 40 and 50 L/min (p < 0.05). Logistic regression analyses were performed to identify which WST and RSST parameters were associated with choking during high-flow nasal cannula therapy. In the adjusted model, the change in swallowing time was an independent predictor of choking during high-flow nasal cannula therapy (OR = 1.02, 95% CI = 1.01–1.04).

Conclusion: A high-flow nasal cannula flow rate of > 40 L/min was associated with decreased swallowing function in healthy subjects. Performance of the WST and RSST are necessary when patients begin eating while undergoing high-flow nasal cannula therapy.

  • Rehabilitation
  • Physiotherapy care
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Swallowing function during high-flow nasal cannula therapy
Masaki Oomagari, Ichiro Fujishima, Norimasa Katagiri, Shinichi Arizono, Koji Watanabe, Tomohisa Ohno, Hiroshi Maeda, Motoki Moriwaki, Mariko Fujimori, Shohei Ohgi
European Respiratory Journal Sep 2015, 46 (suppl 59) PA4199; DOI: 10.1183/13993003.congress-2015.PA4199

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Swallowing function during high-flow nasal cannula therapy
Masaki Oomagari, Ichiro Fujishima, Norimasa Katagiri, Shinichi Arizono, Koji Watanabe, Tomohisa Ohno, Hiroshi Maeda, Motoki Moriwaki, Mariko Fujimori, Shohei Ohgi
European Respiratory Journal Sep 2015, 46 (suppl 59) PA4199; DOI: 10.1183/13993003.congress-2015.PA4199
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