Abstract | BACKGROUND: METHODS: Two hundred sixty-three LT patients (January 2001 to July 2005) at a single center were retrospectively reviewed. Each underwent clinical swallowing assessment. Provocative swallowing evaluation (SE) was performed in 149 patients (Group 1); 114 patients did not receive formal SE (Group 2). SE studies were considered positive with laryngeal penetration (PEN) or tracheal aspiration (ASP) of thin liquids. Groups were compared with respect to pre-, peri- and post-operative variables using analysis of variance (ANOVA) and chi-square tests. RESULTS: After LT, 56.7% of patients underwent post-operative SE (mean 19 +/- 20 days), most of whom (87.9%) had fiber-optic endoscopic studies. SE was positive for PEN or ASP in 70.5% (n = 105). Aspiration occurred in 63.8% (n = 67) of positive SEs; 77.6% (n = 52) of ASP assessments were clinically silent. Pre-operative gastroesophageal reflux disease ( GERD) and post-operative complications, including vocal cord paresis, pleural processes, venous thromboses and severe rejection episodes, were more common among Group 1. Group 2 had a significantly reduced hospital length of stay (p = 0.004). CONCLUSIONS: Prospective SE identified strikingly high rates of dysphagia after LT. Because many of these deficits are silent, aggressive pulmonary toilet is especially important after post-operative LT. Pre-operative SE may clarify those at increased risk for new-onset oropharyngeal dysphagia after LT.
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Authors | B Zane Atkins, Melissa S Trachtenberg, Rebecca Prince-Petersen, Gina Vess, Errol L Bush, Keki R Balsara, Shu S Lin, R Duane Davis Jr |
Journal | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
(J Heart Lung Transplant)
Vol. 26
Issue 11
Pg. 1144-8
(Nov 2007)
ISSN: 1557-3117 [Electronic] United States |
PMID | 18022080
(Publication Type: Journal Article)
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Topics |
- Adult
- Deglutition
(physiology)
- Deglutition Disorders
(diagnosis, etiology, prevention & control)
- Female
- Graft Rejection
- Humans
- Larynx
(physiopathology)
- Lung Transplantation
(adverse effects)
- Male
- Middle Aged
- Postoperative Care
(methods)
- Preoperative Care
(methods)
- Prevalence
- Prognosis
- Retrospective Studies
- Risk Factors
- Trachea
(physiopathology)
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