Measurement of Oxygen Desaturation Is Not Useful for the Detection of Aspiration in Dysphagic Stroke Patients
| Autor: | Rainer Dziewas, Tobias Warnecke, Stephan Oelenberg, Jens Burchard Schröder, Inga Claus, Paul Muhle, Thomas Marian, Christina Hamacher, Sonja Suntrup-Krüger |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
lcsh:Diseases of the circulatory (Cardiovascular) system Stroke patient Oxygen desaturation measurement 0302 clinical medicine Respiratory Aspiration of Gastric Contents Risk Factors Fiber Optic Technology 030212 general & internal medicine Dysphagic stroke patients Aged 80 and over medicine.diagnostic_test Middle Aged Dysphagia Stroke Neurology Predictive value of tests Female medicine.symptom Cardiology and Cardiovascular Medicine Risk assessment medicine.medical_specialty Laryngoscopy Risk Assessment 03 medical and health sciences Swallowing Predictive Value of Tests medicine otorhinolaryngologic diseases Humans Aged Fiberoptic endoscopic evaluation of swallowing Original Paper Oxygen desaturation business.industry fungi Reproducibility of Results Surgery Deglutition Oxygen Pulse oximetry Aspiration lcsh:RC666-701 Neurology (clinical) business Deglutition Disorders Blood Gas Monitoring Transcutaneous 030217 neurology & neurosurgery Biomarkers |
| Zdroj: | Cerebrovascular Diseases Extra, Vol 7, Iss 1, Pp 44-50 (2017) Cerebrovascular Diseases Extra |
| ISSN: | 1664-5456 |
| Popis: | Background: Dysphagia is one of the most dangerous symptoms of acute stroke. Various screening tools have been suggested for the early detection of this condition. In spite of conflicting results, measurement of oxygen saturation (SpO2) during clinical swallowing assessment is still recommended by different national guidelines as a screening tool with a decline in SpO2 ≥2% usually being regarded as a marker of aspiration. This paper assesses the sensitivity of SpO2 measurements for the evaluation of aspiration risk in acute stroke patients. Methods: Fifty acute stroke patients with moderate to severe dysphagia were included in this study. In all patients, fiberoptic endoscopic evaluation of swallowing (FEES) was performed according to a standardised protocol. Blinded to the results of FEES, SpO2 was monitored simultaneously. The degree of desaturation during/after swallows with aspiration was compared to the degree of desaturation during/after swallows without aspiration in a swallow-to-swallow analysis of each patient. To minimise potential confounders, every patient served as their control. Results: In each subject, a swallow with and a swallow without aspiration were analysed. Overall, aspiration seen in FEES was related to a minor decline in SpO2 (mean SpO2 without aspiration 95.54 ± 2.7% vs. mean SpO2 with aspiration 95.28 ± 2.7%). However, a significant desaturation ≥2% occurred only in 5 patients during/after aspiration. There was no correlation between aspiration/dysphagia severity or the amount of aspirated material and SpO2 levels. Conclusions: According to this study, measurement of oxygen desaturation is not a suitable screening tool for the detection of aspiration in stroke patients. |
| Databáze: | OpenAIRE |
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