The Impact of High-Flow Nasal Cannula on Swallow Function
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 18
- 试验地点
- 1
- 主要终点
- Swallow Frequency Recorded by Surface Electromyography (sEMG)
研究概览
简要总结
Background: High-flow nasal cannula (HFNC) is a non-invasive heated and humidified oxygen delivery device that is capable of delivering high-flow rates. It is a relatively new modality that has been introduced as an alternative to conventional oxygen therapy. The clinical value of the use of HFNC is not limited to its ventilation and oxygenation effects, it enables the patient to talk and is purported to permit oral feeding during oxygen therapy despite the limited evidence regarding its impact on swallow function. This study will determine the impact of different flow rates of a high-flow nasal cannula on spontaneous swallowing frequency at rest and swallowing effort and timing while swallowing. Methods: This is a prospective study designed to measure swallowing frequency and swallowing effort in fifty healthy adult volunteers. Participants will receive three levels of HFNC flow rates (30, 45, and 60 L/min) through nasal prongs. The study participants will be asked to swallow measured amounts of water and applesauce and subjected to each flow rate for 15 minutes. Swallowing effort measurement through surface electromyography (sEMG) will be recorded at baseline and the three levels of HFNC flow rates interventions.
详细描述
High-flow nasal cannula (HFNC) is a non-invasive heated and humidified oxygen delivery device that is capable of delivering up to 60 L/min of flow. It is a relatively new modality that has been introduced as an alternative to conventional oxygen therapy in patients with chronic obstructive pulmonary disease (COPD) respiratory failure, obstructive sleep apnea (OSA)6, post-extubation, and status asthmaticus The humidified gas preserves mucociliary function that prevents secretion retention and enhances patient's comfort. This feature allows prolonged use of HFNC in clinical sittings of up to 30 days
In addition to its ability to provide adequate humidification levels, HFNC has various respiratory physiological effects. These physiological effects include: alveolar recruitment, dead space washout, and decreased airway resistance. The clinical value of the use of HFNC is not limited to its ventilation and oxygenation effects, it enables the patient to talk and is purported to permit oral feeding during oxygen therapy.
Currently, despite the fact that patients are often permitted to eat while receiving HFNC therapy, there is insufficient evidence regarding the impact of HFNC on swallow function. The uncertainty of the effect of this oxygen delivery device on swallow function arises not only from the limited number of studies, but also the contradictory results. For example, Sanuki et al. reported that increasing the flow rates of the HFNC resulted in enhanced swallow function by reducing reflex latency. Based on their findings, the researchers suggested that the use of HFNC should not affect the decision to start or resume feeding. Similarly, Lader et al. proposed that the use of high-flow nasal cannula should not delay oral alimentation. On the contrary, Ferrara et al. conducted a study in neonates and concluded that providing feeding while using Nasal Continuous Positive Airway Pressure (nCPAP) increased the risk of aspiration. These opposing outcomes support the need for further studies to obtain more definitive evidence.
Methods:
Spontaneous Swallowing Frequency:
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 21 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •21 years of age or older
- •No cognitive impairments
排除标准
- •Less than 21 years old
- •History of swallow dysphagia
- •History of disease/condition that may cause dysphagia
- •Use of medications that may alter swallow function
- •Nasal obstruction
- •Presence of tracheostomy tube
研究组 & 干预措施
High-Flow/Swallow
All participants will be subjected to all three flows randomly. All participants will be asked swallow water and applesauce
干预措施: Airvo 2; High-Flow nasal cannula system (Device)
结局指标
主要结局
Swallow Frequency Recorded by Surface Electromyography (sEMG)
时间窗: each swallow frequency exam took 1 minute, exams were done for each flow rate which took up to 2 hours to complete
Number of swallows
次要结局
未报告次要终点
研究者
Brady Scott
Associate Professor, Director of Clinical Education
Rush University Medical Center