Preliminary findings on the nature of dysphagia in patients with chronic obstructive pulmonary disease

Abstract

Findings on 14 patients referred for swallowing evaluations from the pulmonary unit of a rehabilitation hospital are presented. Patients were admitted to the hospital with the primary diagnosis of chronic obstructive pulmonary disease (COPD). Thirteen patients had tracheostomy tubes, and five were ventilator-dependent. Each patient received a bedside evaluation to assess the oral phase of the swallow, as well as videofluoroscopy to examine the pharyngeal phase. Results indicated that nearly all of the patients experienced some difficulty with both phases of swallowing. Oral and pharyngeal transit times were consistently slower than normal. Most patients demonstrated diminished coordination and strength of the oral and pharyngeal musculature. The overall picture was one of reduced strength in all aspects of the swallow, coupled with a reduced ability to use pulmonary air to clear the larynx and ensure airway protection. Consistent aspiration was observed in only 3 of the 14 patients, but 10 of the patients were judged to have a moderate swallowing dysfunction.