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[DYSPHAGIA] Cuffed Trach and aspiration


  • Subject: [DYSPHAGIA] Cuffed Trach and aspiration
  • From: QuinnD@rvh.on.ca (Quinn, Darin)
  • Date: Thu, 20 Dec 2001 15:46:02 -0500

Along a similar vein, does anyone have any recent references handy that talk
about tracheostomy cuffs and aspiration?  I do have some information from a
good trach and swalIowing text but it's from 1995 and I thought something
more recent would make a better defense.   A colleague of mine was asked by
ENT to do a swallowing assessment on a young lady in a vegetative state
specifically to check for aspiration of secretions.  I don't know the whole
story, but it sounds like they are looking at getting the trach removed but
the ENT feels that the cuffed trach (I believe it's a Shiley #6) is
preventing any aspiration of secretions that might be happening and is
hesitant to remove it or even deflate the cuff for any period of time.  My
understanding from past reading is that this is 'old school' thinking and
that the cuff really has no real role in preventing aspiration and is
questionable for anyone not on a ventilator.    I will also suggest
discussing the not so linear relationship between aspiration and pneumonia
as well as the greater importance of consistent good oral care but thought a
good place to start would be the role (or non role) of cuffs with regard to
swallowing.  

Thanks in advance,

Darin


> ----------
> From: 	VOLIN ROBERT[SMTP:ROBERT_VOLIN@NYMC.EDU]
> Sent: 	December 20, 2001 1:41 PM
> To: 	dysphagia@medonline.com
> Subject: 	RE: [DYSPHAGIA] vent pts
> 
> 
> Steve Leder published research in a recent issue of Dysphagia to the
> effect
> that, other variables aside, a patient with an uncapped trach is no more
> likely to aspirate than a patient with a capped/valved trach.
> 
> 
> > All this being true, how do people feel about feeding vent pts without
> > valves?
> > 
> > 
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