Ann Rehabil Med.  2015 Aug;39(4):517-523. 10.5535/arm.2015.39.4.517.

The Effects of the VFSS Timing After Nasogastric Tube Removal on Swallowing Function of the Patients With Dysphagia

• Nam DH
• Jung AY
• Cheon JH
• Kim H
• Kang EY
• Lee SH

• KMID: 2148221
• DOI: http://doi.org/10.5535/arm.2015.39.4.517

Abstract

OBJECTIVE
To evaluate the effects of the videofluoroscopic swallowing study (VFSS) timing after the nasogastric tube (NGT) removal on swallowing function of the patients with dysphagia.
METHODS
This study was conducted on 40 NGT-fed patients with dysphagia. To assess the patients' swallowing function, VFSS was performed twice using a 5-mL 35% diluted barium solution. For the initial examination, VFSS was performed immediately after the NGT removal (VFSS 1). For the second examination, VFSS was performed five hours after the NGT removal (VFSS 2). We used the functional dysphagia scale (FDS) to assess swallowing function. In the FDS, a significant difference in the four items in the oral phase, seven items in the pharyngeal phase, and total scores were assessed (p<0.05). We also used modified penetration-aspiration scale (mPAS) to compare the two examinations (p<0.05).
RESULTS
A paired t-test was performed to confirm the statistical significance of the two examinations (p<0.05). The overall swallowing function was assessed as better in VFSS 2 than in VFSS 1. In the FDS, significant differences in the residue in valleculae (p=0.002), the residue in pyriform sinuses (p=0.001), the coating of pharyngeal wall after swallow (p=0.001), and the total scores (p<0.001) were found between the two examinations. Also, in the mPAS that assessed the degree of penetration-aspiration, a significant difference was found between the two examinations (p<0.001).
CONCLUSION
The results of this study confirmed that the timing of the VFSS after the NGT removal affects the swallowing function. Thus, to accurately assess the swallowing function, VFSS must be performed in NGT-fed patients after they have rested for a certain period following the removal of their NGT.

Keyword

Dysphagia; Enteral Nutrition; Deglutition

MeSH Terms

Barium
Deglutition Disorders*
Deglutition*
Enteral Nutrition
Humans
Pyriform Sinus
Barium

Figure

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  Fig. 1 The result of the modified penetration-aspiration scale (mPAS) between VFSS 1 and VFSS 2 (n=40). VFSS, videofluoroscopic swallowing study.

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