High-ﬂow nasal cannula oxygen therapy was effective for dysphagia associated with respiratory muscle paralysis due to cervical spinal cord injury

Medicine, 2021 · DOI: 10.1097/MD.0000000000026907 · Published: August 6, 2021

Simple Explanation

Respiratory muscle paralysis from a cervical spinal cord injury (CSCI) can cause difficulty swallowing. This is because breathing and swallowing need to be coordinated. High-flow nasal cannula (HFNC) oxygen therapy, which provides a constant flow of heated and humidified oxygen, can help improve swallowing in these patients. This case report shows how HFNC oxygen therapy improved swallowing in a patient with dysphagia (difficulty swallowing) caused by respiratory muscle paralysis after a low CSCI.

Study Duration

Not specified

Participants

One 87-year-old male

Evidence Level

Level 4: Case Report

Key Findings

1
HFNC oxygen therapy improved swallowing function in a patient with dysphagia related to respiratory muscle paralysis following CSCI.
2
HFNC oxygen therapy may have prolonged the apnea tolerance time during swallowing, allowing the laryngeal closure structure to remain closed until swallowing is complete.
3
HFNC oxygen therapy may have improved the timing of swallowing by shortening the latency of the swallowing reflex.

Research Summary

This case report describes an 87-year-old man who developed dysphagia (difficulty swallowing) due to respiratory muscle paralysis after a cervical spinal cord injury (CSCI). High-flow nasal cannula (HFNC) oxygen therapy was used, and the patient's swallowing function improved, allowing him to resume oral intake without developing aspiration pneumonia. The authors suggest that HFNC oxygen therapy may help improve swallowing function in patients with dysphagia related to respiratory muscle paralysis due to CSCI.

Practical Implications

Early Swallowing Therapy

HFNC oxygen therapy can facilitate both indirect and direct early swallowing therapy to restore both swallowing and respiratory function.

Reduced Aspiration Risk

HFNC oxygen therapy may prolong the apnea tolerance time during swallowing, reducing the risk of aspiration.

Improved Swallowing Function

HFNC oxygen therapy may improve the timing of swallowing by shortening the latency of the swallowing reflex.

Study Limitations

1
Single case report limits generalizability.
2
Baseline FEES (flexible endoscopic evaluation of swallowing) was not performed.
3
Postoperative FVC (forced vital capacity) was not measured.

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