Enhancing Swallowing Function in Tracheotomy Patients with Subglottic Oxygen Flow: A Randomized Self-Controlled Crossover Trial.

To investigate the effect of oxygen airflow administered through a subglottic suction tube on the swallowing function of stroke patients with tracheotomies. This study used randomized self-controlled cross-over design. A total of 20 patients with dysphagia following tracheotomy related to stroke were enrolled. Patients were assessed using fiberoptic endoscopic evaluation of swallowing (FEES) as they swallowed 5 ml of thickness liquid under five different conditions: continuous oxygen airflow through the subglottic suction tube at three varying flow rates (3 L/min, 5 L/min, and 7 L/min) with the tube cuff inflated, the tube cuff deflated, and the tracheal tube capped. The Rosenbek penetration aspiration scale (PAS) and Yale Pharyngeal Residue Scale(YPR-SRS) were employed to evaluate swallowing residue and aspiration. When continuous subglottic oxygen airflow was administered at 5 L/min and 7 L/min, the PAS scores were significantly lower compared to the conditions of cuff deflation and tracheal tube capping. Additionally, the PAS scores at a subglottic oxygen airflow rate of 3 L/min were significantly lower than the condition with the tube cuff deflated (P < 0.01). Furthermore, the YPR-SRS scores during continuous subglottic oxygen airflow at 5 L/min were significantly lower than those observed with the tube cuff deflated and the tracheal tube capped (P < 0.01). The continuous administration of oxygen airflow through the subglottic suction tube significantly enhanced the safety and efficiency of swallowing in stroke patients with tracheotomy and dysphagia, which expected to be widely used in clinical practice.