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A Systematic Review of Tracheostomy Modifications and Swallowing in Adults

Dysphagia occurs in 11% to 93% of patients following tracheostomy. Despite its benefits, the tracheostomy often co-exists with dysphagia given its anatomical location, the shared pathway of the respiratory and alimentary systems, and the medical complexities necessitating the need for the artificial...

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Autores principales: Skoretz, Stacey A., Anger, Nicole, Wellman, Leslie, Takai, Osamu, Empey, Allison
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202464/
https://www.ncbi.nlm.nih.gov/pubmed/32377977
http://dx.doi.org/10.1007/s00455-020-10115-0
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author Skoretz, Stacey A.
Anger, Nicole
Wellman, Leslie
Takai, Osamu
Empey, Allison
author_facet Skoretz, Stacey A.
Anger, Nicole
Wellman, Leslie
Takai, Osamu
Empey, Allison
author_sort Skoretz, Stacey A.
collection PubMed
description Dysphagia occurs in 11% to 93% of patients following tracheostomy. Despite its benefits, the tracheostomy often co-exists with dysphagia given its anatomical location, the shared pathway of the respiratory and alimentary systems, and the medical complexities necessitating the need for the artificial airway. When tracheostomy weaning commences, it is often debated whether the methods used facilitate swallowing recovery. We conducted a systematic review to determine whether tracheostomy modifications alter swallowing physiology in adults. We searched eight electronic databases, nine grey literature repositories and conducted handsearching. We included studies that reported on oropharyngeal dysphagia as identified by instrumentation in adults with a tracheostomy. We accepted case series (n > 10), prospective or retrospective observational studies, and randomized control trials. We excluded patients with head and neck cancer and/or neurodegenerative disease. Two independent and blinded reviewers rated abstracts and articles for study inclusion. Data abstraction and risk of bias assessment was conducted on included studies. Discrepancies were resolved by consensus. A total of 7079 citations were identified, of which, 639 articles were reviewed, with ten articles meeting our inclusion criteria. The studies were heterogeneous in study design, patient population, and outcome measures. For these reasons, we presented our findings descriptively. All studies were limited by bias risk. This study highlights the limitations of the evidence and therefore the inability to conclude whether tracheostomy modifications alter swallowing physiology.
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spelling pubmed-72024642020-05-07 A Systematic Review of Tracheostomy Modifications and Swallowing in Adults Skoretz, Stacey A. Anger, Nicole Wellman, Leslie Takai, Osamu Empey, Allison Dysphagia Original Article Dysphagia occurs in 11% to 93% of patients following tracheostomy. Despite its benefits, the tracheostomy often co-exists with dysphagia given its anatomical location, the shared pathway of the respiratory and alimentary systems, and the medical complexities necessitating the need for the artificial airway. When tracheostomy weaning commences, it is often debated whether the methods used facilitate swallowing recovery. We conducted a systematic review to determine whether tracheostomy modifications alter swallowing physiology in adults. We searched eight electronic databases, nine grey literature repositories and conducted handsearching. We included studies that reported on oropharyngeal dysphagia as identified by instrumentation in adults with a tracheostomy. We accepted case series (n > 10), prospective or retrospective observational studies, and randomized control trials. We excluded patients with head and neck cancer and/or neurodegenerative disease. Two independent and blinded reviewers rated abstracts and articles for study inclusion. Data abstraction and risk of bias assessment was conducted on included studies. Discrepancies were resolved by consensus. A total of 7079 citations were identified, of which, 639 articles were reviewed, with ten articles meeting our inclusion criteria. The studies were heterogeneous in study design, patient population, and outcome measures. For these reasons, we presented our findings descriptively. All studies were limited by bias risk. This study highlights the limitations of the evidence and therefore the inability to conclude whether tracheostomy modifications alter swallowing physiology. Springer US 2020-05-06 2020 /pmc/articles/PMC7202464/ /pubmed/32377977 http://dx.doi.org/10.1007/s00455-020-10115-0 Text en © Springer Science+Business Media, LLC, part of Springer Nature 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Skoretz, Stacey A.
Anger, Nicole
Wellman, Leslie
Takai, Osamu
Empey, Allison
A Systematic Review of Tracheostomy Modifications and Swallowing in Adults
title A Systematic Review of Tracheostomy Modifications and Swallowing in Adults
title_full A Systematic Review of Tracheostomy Modifications and Swallowing in Adults
title_fullStr A Systematic Review of Tracheostomy Modifications and Swallowing in Adults
title_full_unstemmed A Systematic Review of Tracheostomy Modifications and Swallowing in Adults
title_short A Systematic Review of Tracheostomy Modifications and Swallowing in Adults
title_sort systematic review of tracheostomy modifications and swallowing in adults
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202464/
https://www.ncbi.nlm.nih.gov/pubmed/32377977
http://dx.doi.org/10.1007/s00455-020-10115-0
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