Abstract
Objective
The advantages of nasal high-flow oxygen therapy (NHF) include not only allowing talking, but also eating and drinking, during the therapy. However, the effect of NHF on the swallowing reflex remains unclear. In the present study, we aimed to assess the effects of NHF on the swallowing reflex.
Methods
Nine healthy adult Japanese male volunteers with no history of dysphagia or diseases that may cause dysphagia, such as stroke or Parkinson’s disease, were evaluated. Participants received one of four levels of NHF intervention (0 (control), 15, 30 and 45 L/min of oxygen) with the NHF system through the nasal cannula. Swallowing was induced by the administration of a bolus injection of 5 mL of distilled water over 3 s through a polyethylene catheter at each level of oxygen flow. The primary end-point was the latency period of the swallowing reflex after bolus injection, which was defined as the time from the start of the bolus injection to the onset of the electromyogram (EMG) burst of the first swallow.
Results
Mean latency times of the swallowing reflex with 15 (9.8 ± 2.9 s), 30 (9.0 ± 2.7 s) and 45 (8.5 ± 3.0 s) L/min of NHF were significantly shorter than those under control conditions (11.9 ± 3.7 s; P < 0.05).
Conclusions
Our study demonstrates that NHF may enhance swallowing function with increasing levels of NHF by reducing the latency of the reflex.
Clinical relevance
NHF may allow continuation of oral intake without aspiration during oxygen therapy.
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Acknowledgments
We would like to thank Dr. Stanislav Tatkov (Fisher & Paykel Healthcare) for reviewing our paper and giving us suggestions that significantly improved our paper. Dr. Sanuki would like to extend his indebtedness to his deceased brother, Mr. Yoshiro Sanuki, for his support and encouragement throughout the study.
The preliminary data of this study were presented as a poster presentation at Euroanaesthesia 2015 (The European Anaesthesiology Congress), June 1, 2015, Berlin.
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Ethical approval
Ethical approval for this study (Ref No. 1395) was provided by the ethics committee of the Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan (Chairperson Prof. Takehiko Koji) on Dec 27, 2013.
Funding
This work was partially supported by a 2014 research grant from the General Foundation Hojin-kai, Nagasaki University Hospital.
Conflicts of interest
The authors declare that they have no conflicts of interest.
Informed consent
Informed consent was obtained from all individual participants included in the study.
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Sanuki, T., Mishima, G., Kiriishi, K. et al. Effect of nasal high-flow oxygen therapy on the swallowing reflex: an in vivo volunteer study. Clin Oral Invest 21, 915–920 (2017). https://doi.org/10.1007/s00784-016-1822-3
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DOI: https://doi.org/10.1007/s00784-016-1822-3