To determine the incidence of penetration/aspiration in patients presenting with a COPD exacerbation. Is there a relationship between the severity of tracheal penetration or aspiration and spirometry in patients with a COPD exacerbation?.
Prospective study of twenty-one consecutive and eligible patients with the diagnosis of an acute COPD exacerbation admitted to a university based tertiary care hospital. Patients underwent a videofluroscopic evaluation of swallowing and spirometry. consistencies were administered, for purposes of diet recommendation only, analysis was done only with thin liquid consistency (100 mls total volume swallowed). Spirometry and the swallowing assessment were carried out during the acute hospital admission. An eight-point Penetration/Aspiration Scale developed by Rosenbek et al (1996) was used to quantify the presence and severity of tracheal penetration or aspiration. Spirometry measures included FEV1, FVC and the FEV1/FVC, all values met ATS standards.
Penetration (contrast entering the trachea but not passing the vocal cords) was seen in 10/21 patients. Aspiration or silent aspiration occurred in 10/21 patients. One patient had no contrast enter the trachea. There was no obvious relationship between the severity ratings of penetration/aspiration and the severity of the airflow obstruction seen on spirometry.
The incidence of penetration/aspiration in patients presenting with COPD exacerbation is of significance. There does not appear to be a correlation between the severity of the airflow obstruction and the degree degree of penetration or aspiration of thin fluids in the population.
This study implies that a significant number of patients presenting with a COPD exacerbation have evidence of unrecognized penetration/aspiration. Consideration of the implications on dietary recommendations may need to be considered in this patient population.
Karen Laframboise, None.