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Head & Face Medicine Jul 2016To review the cases of accidental aspiration and ingestion of foreign objects during dental procedure, and to emphasize the importance of thorough documentation of the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To review the cases of accidental aspiration and ingestion of foreign objects during dental procedure, and to emphasize the importance of thorough documentation of the accidents.
METHODS
A comprehensive search on (dental procedure/treatment/practice), (aspiration/inhalation), and (ingestion/swallow) was performed for all years before 1st October 2014 available. The statistic analysis was made on the variables including journals and reported year, patients' age, gender, general conditions, dental procedure and location for procedure, foreign objects, site of involvement, possible causes, anesthesia during procedure and treatment, symptoms, treatment time and treatment modality, follow-up, and so on.
RESULTS
A total of 617 cases reported by 45 articles from 37 kinds of journals were included and analyzed. Most reports made detailed record. While some important variables were recorded incompletely, including patient's general conditions, location for procedure, clinical experience of the involving dentists, tooth position of procedure, possible causes, and anesthesia during procedure and treatment for the accident.
CONCLUSIONS
Aspiration and ingestion of foreign objects are rare and risky complication during dental procedure. Each accident should have thorough documentation so as to provide enough information for the treatment and prevention.
Topics: Deglutition; Dental Care; Documentation; Female; Foreign Bodies; Humans; Incidence; Lung; Male; Prognosis; Respiratory Aspiration; Risk Assessment; Stomach
PubMed: 27449659
DOI: 10.1186/s13005-016-0120-2 -
British Journal of Anaesthesia Mar 2017Although pulmonary aspiration complicating operative general anaesthesia has been extensively studied, little is known regarding aspiration during procedural sedation. (Review)
Review
BACKGROUND
Although pulmonary aspiration complicating operative general anaesthesia has been extensively studied, little is known regarding aspiration during procedural sedation.
METHODS
We performed a comprehensive, systematic review to identify and catalogue published instances of aspiration involving procedural sedation in patients of all ages. We sought to report descriptively the circumstances, nature, and outcomes of these events.
RESULTS
Of 1249 records identified by our search, we found 35 articles describing one or more occurrences of pulmonary aspiration during procedural sedation. Of the 292 occurrences during gastrointestinal endoscopy, there were eight deaths. Of the 34 unique occurrences for procedures other than endoscopy, there was a single death in a moribund patient, full recovery in 31, and unknown recovery status in two. We found no occurrences of aspiration in non-fasted patients receiving procedures other than endoscopy.
CONCLUSIONS
This first systematic review of pulmonary aspiration during procedural sedation identified few occurrences outside of gastrointestinal endoscopy, with full recovery typical. Although diligent caution remains warranted, our data indicate that aspiration during procedural sedation appears rare, idiosyncratic, and typically benign.
Topics: Anesthesia, General; Humans; Intraoperative Complications; Respiratory Aspiration
PubMed: 28186265
DOI: 10.1093/bja/aex004 -
Jornal Brasileiro de Pneumologia :... 2018
Topics: Child; Female; Foreign Bodies; Humans; Lung, Hyperlucent; Respiratory Aspiration; Tomography, X-Ray Computed
PubMed: 30043881
DOI: 10.1590/S1806-37562018000000092 -
Otolaryngology--head and Neck Surgery :... Feb 2015To appraise the current videofluoroscopic evidence on the reduction of aspiration using thickened liquids in the head and neck cancer population. (Review)
Review
OBJECTIVE
To appraise the current videofluoroscopic evidence on the reduction of aspiration using thickened liquids in the head and neck cancer population.
DATA SOURCES
Search terms relating to deglutition or dysphagia or swallow and neoplasms and oncology or head and neck cancer and viscosity or texture and apira or residu* were combined with honey or nectar, xerostomia, and respiratory aspiration using Boolean operators.
REVIEW METHODS
A multiengine literature search identified 337 nonduplicate articles, of which 6 were judged to be relevant. These underwent detailed review for study quality and qualitative synthesis.
RESULTS
The articles reviewed in detail predominantly described heterogeneous study samples with small sample sizes, making for difficult interpretation and generalization of results. Rates of aspiration were typically not reported by bolus consistency, despite the fact that a variety of stimulus consistencies was used during a videofluoroscopic swallowing study. Studies confirmed that aspiration is a major concern in the head and neck cancer population and reported a trend toward more frequent aspiration after (chemo)radiotherapy.
CONCLUSION
Overall, the literature on thickened liquids as an intervention to eliminate aspiration in the head and neck cancer population is limited. Because aspiration is known to be prevalent in the head and neck cancer population and thickened liquids are known to eliminate aspiration in other populations, it is important to determine the effectiveness of thickened liquids for reducing aspiration in the head and neck cancer population.
Topics: Deglutition Disorders; Enteral Nutrition; Head and Neck Neoplasms; Humans; Respiratory Aspiration; Video Recording; Viscosity
PubMed: 25358345
DOI: 10.1177/0194599814556239 -
Pulmonary Pharmacology & Therapeutics Jun 2011Aspiration is a common result of stroke, and may lead to lung infections and pneumonia. Cough may prevent this aspiration and thus prevent the pneumonia. We review the...
Aspiration is a common result of stroke, and may lead to lung infections and pneumonia. Cough may prevent this aspiration and thus prevent the pneumonia. We review the four types of cough usually used to assess aspiration risk: voluntary cough (VC), reflex cough (RC), the laryngeal expiration reflex (LER), and cough on swallow (CoS). VC is easy to test but starts with an inspiration that may cause aspiration, and is controlled by cortico-brainstem pathways that may not be involved in influencing aspiration. RC also starts with an inspiration, and requires instrumental intervention, but is more relevant to protecting the lungs. The LER starts with an expiration, so is 'anti-aspiration', and is easy to test, but its neural mechanisms have not been fully analysed. CoS can be tested at the same time as direct observations of aspiration, but little is known about its neural mechanisms. Each method has its advocates, and the purpose of the review is to discuss how each may be applied and how the information from each may be assessed and valued.
Topics: Animals; Brain Stem; Cerebral Cortex; Cough; Deglutition; Exhalation; Humans; Larynx; Pneumonia, Aspiration; Reflex; Respiratory Aspiration; Stroke
PubMed: 21338708
DOI: 10.1016/j.pupt.2011.01.015 -
PloS One 2021NPC is the most widely found malignant tumor in the head and neck region in Indonesia. Chemoradiation therapy for NPC can induce swallowing disorders (dysphagia) that...
NPC is the most widely found malignant tumor in the head and neck region in Indonesia. Chemoradiation therapy for NPC can induce swallowing disorders (dysphagia) that adversely affects a patients quality of life. This study aimed to assess the swallowing process by flexible endoscopic evaluation of swallowing in patients with nasopharyngeal carcinoma after chemoradiation. Thirty-nine patients with NPC who had chemoradiation therapy more than one month previously underwent flexible endoscopic evaluation of swallowing and were assessed for oral transport time, sensation, standing-secretion, pre-swallowing leakage, residue, penetration, aspiration, and silent aspiration. The most common structural abnormalities were an upright and swollen epiglottis (89.4%), poor oral hygiene, and velopharyngeal closure defects (56.4%). This examination also revealed a mild degree of standing secretion (38.5%) and aspiration (10.3%). No penetration was observed in 64.1% of the patients, and no silent aspiration was observed in any of the patients. A severe degree of residue (45.7%) was observed when administering oatmeal, while the residue was mild to moderate when administering gastric rice, crackers, and milk. The residue changed to a mild degree (32.3%-51.4%) in all food administrations after the watering maneuver. The highest penetration was noted after oatmeal administration (42.8%), and the highest aspiration was found after milk administration (8.6%). Standing secretion in almost all patients was caused by hyposensitivity of the hypopharynx. Persistent residue and hyposensitivity of the hypopharynx led to aspiration. The low percentage of aspiration and silent aspiration might have been caused by the upright and swollen epiglottis that prevented aspiration. Poor oral hygiene and a dry mouth led to prolonged oral transport. Therefore, most patients had hypopharyngeal abnormalities in the form of a swollen and upright epiglottis. Secretion and food residue were also detected. Drinking helps to expedite the swallowing process by facilitating oral phase transport and reducing residues.
Topics: Adult; Chemoradiotherapy; Deglutition Disorders; Endoscopy, Digestive System; Female; Humans; Male; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Respiratory Aspiration
PubMed: 34882745
DOI: 10.1371/journal.pone.0261110 -
Revista Latino-americana de Enfermagem 2015to investigate the association of risk factors with the Risk for aspiration nursing diagnosis and respiratory aspiration.
OBJECTIVE
to investigate the association of risk factors with the Risk for aspiration nursing diagnosis and respiratory aspiration.
METHOD
cross-sectional study assessing 105 patients with stroke. The instrument used to collect data addressing sociodemographic information, clinical variables and risk factors for Risk for aspiration. The clinical judgments of three expert RNs were used to establish the diagnosis. The relationship between variables and strength of association using Odds Ratio (OR) was verified both in regard to Risk for aspiration and respiratory aspiration.
RESULTS
risk for aspiration was present in 34.3% of the patients and aspiration in 30.5%. The following stood out among the risk factors: Dysphagia, Impaired or absent gag reflex, Neurological disorders, and Impaired physical mobility, all of which were statistically associated with Risk for aspiration. Note that patients who develop such a diagnosis were seven times more likely to develop respiratory aspiration.
CONCLUSION
dysphagia, Impaired or absent gag reflex were the best predictors both for Risk for aspiration and respiratory aspiration.
Topics: Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Nursing Diagnosis; Prognosis; Respiratory Aspiration; Risk Assessment; Risk Factors; Stroke
PubMed: 26039291
DOI: 10.1590/0104-1169.0197.2545 -
Respiratory Medicine Aug 2016The precise coordination between breathing and swallowing is an important mechanism to prevent pulmonary aspiration. Factors that alter breathing patterns and... (Review)
Review
BACKGROUND
The precise coordination between breathing and swallowing is an important mechanism to prevent pulmonary aspiration. Factors that alter breathing patterns and ventilation, such as chronic respiratory diseases, may influence that precise coordination of breathing and swallowing.
PURPOSE
The purpose of this systematic literature review is to examine the effects of chronic respiratory diseases on swallowing function.
METHOD
Literature searches were performed using the electronic databases PubMed and Embase. All articles meeting the eligibility criteria up to March 2016 were included.
RESULTS
All articles included studied Chronic Obstructive Pulmonary Diseases (COPD) or Obstructive Sleep Apnea (OSA); no studies involving other respiratory diseases were found. A total of 1069 abstracts were retrieved, of which twenty-six studies met the inclusion criteria; eleven studies dealt with OSA and fifteen studies dealt with COPD.
CONCLUSION
The outcome data indicate that chronic respiratory diseases increase the prevalence of oropharyngeal dysphagia (OD) in patients. However, the relative small number of studies, differences in selection criteria, definitions and assessment techniques used for diagnosing OSA, COPD, and OD point to the need for further research.
Topics: Adult; Aged; Aged, 80 and over; Deglutition; Deglutition Disorders; Female; Humans; Male; Middle Aged; Prevalence; Pulmonary Disease, Chronic Obstructive; Respiration; Respiratory Aspiration; Sleep Apnea, Obstructive
PubMed: 27492514
DOI: 10.1016/j.rmed.2016.05.024 -
Expert Review of Gastroenterology &... Jun 2020Bulbar dysfunction is common in Parkinson's disease (PD) with more than 80% of affected individuals developing dysphagia during the course of the disease. Symptoms can...
INTRODUCTION
Bulbar dysfunction is common in Parkinson's disease (PD) with more than 80% of affected individuals developing dysphagia during the course of the disease. Symptoms can begin in the preclinical stage and individuals may remain clinically asymptomatic for years. Furthermore, patients may be unaware of swallowing changes, which contributes to the difference between the prevalence of self-reported dysphagia and deficits identified during instrumental evaluations. Dysphagia is underrecognized and contributes to the development of aspiration pneumonia which is the leading cause of death in PD. Dysphagia in PD is complex and not completely understood. Both dopaminergic and nondopaminergic pathways likely underpin dysphagia.
AREAS COVERED
This comprehensive review will cover the epidemiology, pathophysiology, clinical evaluation, and expert management of dysphagia and aspiration in patients with PD.
EXPERT OPINION
A multidisciplinary team approach is important to properly identify and manage PD dysphagia. Regular clinical screenings with objective instrumental assessments are necessary for early detection of dysphagia. Studies are needed to better understand the mechanism(s) involved in PD dysphagia, establish markers for early detection and progression, and develop evidence-based treatment options.
Topics: Deglutition; Deglutition Disorders; Disease Progression; Humans; Parkinson Disease; Pneumonia, Aspiration; Respiratory Aspiration; Risk Factors; Self Report
PubMed: 32657208
DOI: 10.1080/17474124.2020.1769475 -
BMJ Case Reports Sep 2012
Topics: Aged; Anti-Bacterial Agents; Barium; Contrast Media; Deglutition Disorders; Humans; Male; Oxygen Inhalation Therapy; Radiography; Respiratory Aspiration
PubMed: 22962374
DOI: 10.1136/bcr.02.2012.5891