Dysphagia and Associated Respiratory Considerations in Cervical Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2012 · DOI: 10.1310/sci1804-291 · Published: January 1, 2012

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

Dysphagia, or swallowing dysfunction, is a common complication after cervical spinal cord injury (SCI). It can lead to serious issues like hypoxemia and pneumonia. The study aimed to find risk factors for dysphagia after SCI, focusing on respiratory considerations. They evaluated 68 patients with acute cervical SCI. The study found that tracheostomy, ventilator use, and nasogastric tubes were significantly associated with dysphagia. Patients with dysphagia also had higher rates of pneumonia.

Study Duration

Not specified

Participants

68 individuals with acute cervical SCI

Evidence Level

Prospective study

Key Findings

1
Dysphagia was found in 30.9% of individuals with acute cervical SCI.
2
Tracheostomy, ventilator use, and nasogastric tube presence were significantly associated with dysphagia.
3
Individuals with dysphagia had statistically higher occurrences of pneumonia.

Research Summary

This study investigates dysphagia in patients with acute cervical spinal cord injury (SCI) and its association with respiratory complications. The results indicate that dysphagia is relatively common after acute cervical SCI and is significantly associated with tracheostomy, ventilator use, and nasogastric tubes. The study emphasizes the importance of early evaluation and intervention for dysphagia to decrease morbidity and improve clinical outcomes, highlighting the role of respiratory care practitioners.

Practical Implications

Early Dysphagia Screening

Implement routine dysphagia screening for all acute cervical SCI patients to identify and manage swallowing difficulties early.

Aggressive Respiratory Care

Prioritize aggressive respiratory care, including secretion management, to optimize patients' readiness for dysphagia evaluations.

Interdisciplinary Collaboration

Foster close collaboration between physicians, speech-language pathologists, and respiratory care practitioners for coordinated and effective patient care.

Study Limitations

1
The study did not establish a causal relationship between dysphagia and tracheostomy, ventilator dependence, and NG tube.
2
High refusal rate for VFSS (Videofluroscopy swallow study) may have skewed the results.
3
The study population was limited to a single SCI specialty unit, potentially limiting the generalizability of the findings.

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