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Hypoxemia during oral feedings in adults with dysphagia and severe neurological disabilities

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Abstract

Signs of respiratory distress including coughing, choking, and gagging are not uncommon during oral feedings in patients with severe dysphagia. Aspiration pneumonia and chronic lung disease are recognized complications. Pulse oximetry, respiratory inductance plethysmography, and nasal airflow measurement by thermistors are accurate noninvasive methods of monitoring cardiopulmonary adaptation during oral feedings in patients with severe dysphagia. We report significant, previously unrecognized, acquired hypoxemia during oral feedings in two patients with severe cerebral palsy and one with multiple sclerosis. The episodes of hypoxemia occurred only while swallowing specific food textures. Periods of hypoxemia most probably resulted from aspiration during oral feedings. Cardiopulmonary adaptation may prove to be an important consideration in decisions regarding the method and advisability of continued oral feedings in patients with severe dysphagia.

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Authors and Affiliations

  1. Departments of Pediatrics and Neurology and Divisions of Developmental Pediatrics and Developmental and Behavioral Neurosciences, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, USA

    Brian Rogers M.D., Michael Msall M.D. & David Shucard Ph.D.

  2. Children's Hospital of Buffalo, Robert Warner Rehabilitation Center, 936 Delaware Avenue, Buffalo, New York, USA

    Brian Rogers M.D. & Michael Msall M.D.

  3. Buffalo General Hospital, 100 High Street, Buffalo, New York, USA

    David Shucard Ph.D.

Authors
  1. Brian Rogers M.D.
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  2. Michael Msall M.D.
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  3. David Shucard Ph.D.
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Additional information

This study was partially sponsored by the Office of Mental Retardation and Developmental Disabilities of the State of New York.

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Rogers, B., Msall, M. & Shucard, D. Hypoxemia during oral feedings in adults with dysphagia and severe neurological disabilities. Dysphagia 8, 43–48 (1993). https://doi.org/10.1007/BF01351478

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