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Intensive Care Medicine

, Volume 41, Issue 9, pp 1629–1637 | Cite as

Electrical pharyngeal stimulation for dysphagia treatment in tracheotomized stroke patients: a randomized controlled trial

  • Sonja Suntrup
  • Thomas Marian
  • Jens Burchard Schröder
  • Inga Suttrup
  • Paul Muhle
  • Stephan Oelenberg
  • Christina Hamacher
  • Jens Minnerup
  • Tobias Warnecke
  • Rainer Dziewas
Original

Abstract

Purpose

Treatment of post-stroke dysphagia is notoriously difficult with different neurostimulation strategies having been employed with a variable degree of success. Recently, electrical pharyngeal stimulation (EPS) has been shown to improve swallowing function and in particular decrease airway aspiration in acute stroke. We performed a randomized controlled trial to assess EPS effectiveness on swallowing function in severely dysphagic tracheotomized patients.

Methods

All consecutive stroke patients successfully weaned from the respirator but with severe dysphagia precluding decannulation were screened for eligibility. Eligible patients were randomized to receive either EPS (N = 20) or sham stimulation (N = 10) over three consecutive days. Primary endpoint was ability to decannulate the patient. Swallowing function was assessed using fiberoptic endoscopy. Patients having received sham stimulation were offered EPS treatment during unblinded follow-up if required. Investigators were blinded to the patient’s study group allocation.

Results

Both groups were well matched for age, stroke severity, and lesion location. Decannulation after study intervention was possible in 75 % of patients of the treatment group and in 20 % of patients of the sham group (p < 0.01). Secondary outcome parameters did not differ. No adverse events occurred.

Conclusion

In this pilot study, EPS enhanced remission of dysphagia as assessed with fiberoptic endoscopic evaluation of swallowing (FEES), thereby enabling decannulation in 75 % of patients.

Keywords

Electrical pharyngeal stimulation Stroke Dysphagia Decannulation 

Notes

Conflicts of interest

R. Dziewas is a member of the clinical advisory board of Phagenesis Ltd. The other authors declare they have no conflict of interest.

Supplementary material

134_2015_3897_MOESM1_ESM.pdf (143 kb)
Supplementary material 1 (PDF 144 kb)
134_2015_3897_MOESM2_ESM.doc (218 kb)
Supplementary material 2 (DOC 218 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2015

Authors and Affiliations

  • Sonja Suntrup
    • 1
  • Thomas Marian
    • 1
  • Jens Burchard Schröder
    • 1
  • Inga Suttrup
    • 1
  • Paul Muhle
    • 1
  • Stephan Oelenberg
    • 1
  • Christina Hamacher
    • 1
  • Jens Minnerup
    • 1
  • Tobias Warnecke
    • 1
  • Rainer Dziewas
    • 1
  1. 1.Department of NeurologyUniversity Hospital MünsterMünsterGermany

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