title: Influence of External Subglottic Air Flow on Dysphagic Tracheotomized Patients With Severe Brain Injury.
abstract: OBJECTIVE
  The aim of this study was to determine if external subglottic air flow (ESAF) influences swallowing frequency in severely dysphagic tracheotomized patients with brain injury.
  
  
  METHODS
  Ten patients were recruited at the neurological intensive care unit. The ESAF intervention was provided through the standard cuffed suction aid tracheotomy tube, which primarily is used to suction residual secretion volume from the subglottic area. Sessions were 150 minutes, and ESAF was provided at 60-65, 90-95, and 120-125 minutes at 3 L/min. Outcome measures included swallowing frequency (swallows/5 min) at 0-5 minutes (pre-baseline), 25-30 and 55-60 minutes (baseline/control), and 85-90, 115-120, and 145-150 minutes (postintervention). The residual secretion volume (ml) from the subglottic area was collected using a syringe at 0 minutes (pre-baseline), 30 and 60 minutes (baseline/ control), and at 90, 120, and 150 minutes (postintervention).
  
  
  RESULTS
  The mean (±SEM) swallowing frequency (swallows/5 min) increased from 0.60 ± 0.30 to 2.10 ± 0.70 during the ESAF intervention ( P < .001). The mean (±SEM) residual secretion volume reduced from 3.10 ± 0.31 ml to 0.50 ± 0.30 ml after the ESAF intervention ( P < .001).
  
  
  CONCLUSIONS
  The increase in swallowing frequency and reduction in residual secretion volume may indicate that ESAF influences swallowing parameters in patients with tracheotomy tubes.
authors.affiliation: 1 Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark.|2 Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Mohit
authors.initials: M
authors.lastname: Kothari
authors.affiliation: 1 Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark.|3 Intensive Care Unit, Regional Hospital, Silkeborg, Denmark.
authors.forename: Katje
authors.initials: K
authors.lastname: Bjerrum
authors.affiliation: 3 Intensive Care Unit, Regional Hospital, Silkeborg, Denmark.
authors.forename: Lars Hedemann
authors.initials: LH
authors.lastname: Nielsen
authors.affiliation: 1 Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark.
authors.forename: Jim
authors.initials: J
authors.lastname: Jensen
authors.affiliation: 1 Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark.|2 Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: Jørgen Feldbæk
authors.initials: JF
authors.lastname: Nielsen
mesh_terms: D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation*; D003422:Critical Care; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control*; D005260:Female; D005931:Glottis; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012121:Respiration, Artificial; D013396:Suction; D014140:Tracheotomy; D055815:Young Adult
keywords: aspiration; brain injury; deglutition; neurorehabilitation; subglottic air flow; tracheotomy