Affiliation:
1. Department of Otolaryngology SUNY Downstate Health Sciences University Brooklyn USA
2. Division of Speech‐Language Pathology, Orthopedics & Rehabilitation Center Maimonides Health Brooklyn USA
3. Department of Surgery, Division of Otolaryngology Maimonides Health Brooklyn USA
Abstract
AbstractObjectiveDespite widespread use of high flow nasal cannula (HFNC) for respiratory support, the effect of HFNC on swallowing physiology is poorly understood. Flow rates that permit safe swallowing have not been established. We aim to assess if healthy individuals have diminished swallowing function and safety at high flow rates.Study DesignRepeated measures with planned data collection.SettingOutpatient dysphagia clinic.MethodsSwallowing function in a cohort of healthy individuals was assessed using Flexible Endoscopic Evaluation of Swallowing (FEES). Participants' safety of swallowing was assessed with different textures under randomized rates of HFNC (0, 30, 40, 50, and 60 LPM). Swallowing trials included quantities of thin liquids, mildly‐thick liquids, and purees. Trials were scored using the Penetration‐Aspiration Scale (PAS). Pearson chi‐square tests were used to test for correlation between PAS result, flow rate, and consistency across each quantity of material.ResultsTwenty‐seven subjects were enrolled. Forty‐one percent were male with mean age of 34 years (11 standard deviation). Ninety‐nine percent (267/270), 97% (n = 263/270), and 99% (399/405) of 1 sip swallows, 3 sip swallows, and 5 mL swallows, respectively, were safe. There was no significant correlation between swallow safety and flow rate using Pearson Chi‐Square test across all consistencies and across all quantities of materials (P > 0.05). Of note, out of all subtrials, the thin liquid, 3 sips trial at 60 LPM, had the largest percent of unsafe swallows (14%).ConclusionOur results suggest rate of aspiration is not significantly affected by high flow nasal cannula in healthy individuals.