C. Crimi, Rita Chiaramonte, Fabio Vignera, Carlo Vancheri, Michele Vecchio, C. Gregoretti, Annalisa Carlucci, Tiina Andersen, Andrea Cortegiani
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Understanding this relationship is crucial, considering the necessity for patients to maintain adequate nutrition during daytime HFNT.This scoping review aims to synthesise available data on the effects of HFNT flow rates on swallowing function and the possible risk of aspiration during treatment, focusing on knowledge and evidence gaps.PubMed, Scopus, Web of Science and Google Scholar databases were searched from inception to May 30th, 2023, for studies reporting data on swallowing assessment in healthy adults or patients with acute or chronic respiratory failure receiving HFNT. Data on study design, patients’ characteristics, and quality outcomes were extracted, and risk of bias was assessed.Eight studies were included, four including cohorts of healthy volunteers (n=148) and four including patients with acute or chronic respiratory failure (n=151). Study designs, patient populations, and quality outcome measures were heterogeneous. 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引用次数: 0
摘要
高流量鼻饲疗法(HFNT)广泛应用于不同临床环境中的呼吸衰竭患者,但高流量鼻饲疗法对呼吸-吞咽协调的影响尚不清楚。本范围综述旨在综合有关高通鼻流速对吞咽功能的影响以及治疗过程中可能出现的误吸风险的现有数据,重点关注知识和证据缺口。我们检索了 PubMed、Scopus、Web of Science 和 Google Scholar 数据库中从开始到 2023 年 5 月 30 日报告健康成人或接受高通鼻流速治疗的急性或慢性呼吸衰竭患者吞咽评估数据的研究。共纳入 8 项研究,其中 4 项包括健康志愿者队列(n=148),4 项包括急性或慢性呼吸衰竭患者(n=151)。研究设计、患者人群和质量结果衡量标准各不相同。两项研究表明,患者的吞咽功能有所改善,而四项研究则表明,患者在高频呼吸治疗期间的吞咽功能受到了损害;两项研究表明,患者的整体临床表现和潜在病症会影响吞咽-呼吸协调,而非高频呼吸治疗。所有纳入研究的偏倚风险均被判定为较低。本次范围界定综述发现,有关高频NT对吞咽功能影响的证据有限且存在争议。值得注意的是,吞咽功能评估的方法差异很大。需要进行更多的研究来检验高频硝酸纤维素对呼吸-吞咽协调的影响。
Effects of high-flow nasal therapy on swallowing function: a scoping review
High-flow nasal therapy (HFNT) is widely used in patients with respiratory failure in different clinical settings, but the effect of HFNT on respiratory-swallow coordination is unknown. Understanding this relationship is crucial, considering the necessity for patients to maintain adequate nutrition during daytime HFNT.This scoping review aims to synthesise available data on the effects of HFNT flow rates on swallowing function and the possible risk of aspiration during treatment, focusing on knowledge and evidence gaps.PubMed, Scopus, Web of Science and Google Scholar databases were searched from inception to May 30th, 2023, for studies reporting data on swallowing assessment in healthy adults or patients with acute or chronic respiratory failure receiving HFNT. Data on study design, patients’ characteristics, and quality outcomes were extracted, and risk of bias was assessed.Eight studies were included, four including cohorts of healthy volunteers (n=148) and four including patients with acute or chronic respiratory failure (n=151). Study designs, patient populations, and quality outcome measures were heterogeneous. Two studies indicated improvement, while four articles showed impairment in swallowing function during HFNT; two studies showed that patients’ overall clinical picture and underlying medical conditions influence swallowing-breathing coordination rather than HFNTperse. Risk of bias was judged low for all the included studies.This scoping review found limited and controversial evidence of the impact of HFNT on swallowing function. Remarkably, methods for swallowing function assessment were quite heterogeneous. Additional research is required to test the effect of HFNT on respiratory-swallowing coordination.