The Influence of Airflow Via High-Flow Nasal Cannula on Duration of Laryngeal Vestibule Closure
- PDF / 455,468 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 72 Downloads / 143 Views
ORIGINAL ARTICLE
The Influence of Airflow Via High‑Flow Nasal Cannula on Duration of Laryngeal Vestibule Closure Katie Allen1 · Kristine Galek1 Received: 22 May 2020 / Accepted: 21 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The purpose of this experimental study was to investigate the influence of airflow via high-flow nasal cannula (HFNC) on the duration of laryngeal vestibule closure (dLVC) and Penetration-Aspiration Scale (PAS) scores. Twenty-nine healthy adults participated in a repeated-measures design. Each participant completed a videofluoroscopic swallow study while receiving airflow via HFNC across a control condition of zero flow and conditions of 10, 20, 30, 40, 50, and 60 L/min. Five raters rated dLVC and PAS scores. Laryngeal vestibule closure was complete on all swallows. Linear regression revealed that the amount of airflow via HFNC significantly influenced dLVC, F(1, 810) = 19.056, p 80% frequency compared to other PAS scores. Aspiration (PAS 7 or 8) did not occur. A Fisher’s Exact test determined there was no association between normal/abnormal PAS score and no airflow/HFNC (p = .610). Findings indicate that for healthy adults, airflow via HFNC influenced dLVC in a dose-dependent manner with no change in airway invasion. The influence of HFNC on dLVC was a positive relationship, meaning when airflow increased, dLVC increased, and when airflow decreased, dLVC decreased. Modulation of dLVC in response to the amount of airflow highlights the ability of healthy adults to adapt to swallow conditions as needed to protect the airway. Keywords Swallow · Laryngeal vestibule closure · High-flow nasal cannula · Airway invasion
Introduction The number of hospitalizations associated with respiratory failure has steadily increased in the USA [1] and will likely escalate exponentially, considering the recent COVID-19 pandemic. In a 2009 survey, respiratory failure resulted in 380,000 deaths and over $54 billion in costs [1]. Severe respiratory failure requires mechanical ventilation to assist with gas exchange and reduce the work of breathing for patients. Mechanical ventilation works by blowing positive air pressure into the lungs, which stents the airway open [2–5]. There are invasive and non-invasive types of mechanical ventilation. Invasive ventilation requires placement of a tracheostomy or endotracheal tube. Non-invasive ventilation utilizes a facial mask or high-flow nasal cannula. Compared * Katie Allen [email protected] Kristine Galek [email protected] 1
University of Nevada, 1664 North Virginia Street, Mailstop 0152, Reno, NV 89557, USA
to invasive ventilation, non-invasive ventilation is associated with fewer infections, fewer prescribed antibiotics, lower mortality, and shorter stays in the intensive care unit [6, 7]. Non-invasive ventilation delivered using a high-flow nasal cannula (HFNC) is a more recent development [8]. HFNC provides precise adjustment of airflow up to 60 L/min [2]. Additionally, patients tolerate HFNC to a greate
Data Loading...
