EFFECTIVENESS OF EFA (EXPIRATORY FLOW ACCELERATOR) TECHNOLOGY IN THE PREVENTION OF ASPIRATION PNEUMONIA IN DYSPHAGIA: CLINICAL CASE IN GASTROESOPHAGEAL JUNCTION ADENOCARCINOMA : Research Article

Giorgio Mandala

doi:10.58372/2835-6276.1050

Authors

Giorgio Mandala

DOI:

https://doi.org/10.58372/2835-6276.1050

Abstract

Background: “Ab ingestis” pneumonia is the second most common cause of nosocomial infections in inpatients and the most common cause of death in patients with dysphagia. Early interdisciplinary rehabilitation protocols could reduce penetration-aspiration episodes.

Aim: This clinical case evaluates the effects of an expiratory flow accelerator (EFA^®) device - usually aimed to manage airway secretions - in addition to usual care to prevent the penetration-aspiration (PA) risk in bedridden dysphagic low-alert patients, with ineffective cough.

Methods: We analyzed the use of expiratory flow accelerator with a protocol to prevent relapses of PA compared with traditional treatments in cooperative patients.

Conclusion This results showed the feasibility and reliability of the EFA^®to prevent PA episodes in high risk dysphagic patients and provides the framework to design a trial.

Clinical rehabilitation impact: the use of EFA® technology could be assessed and used in patients with severe acquired brain injury and ineffective cough.

References

G. Garuti, M Lusuardi, B. Turola, E. Verucchi, M. Giovannini The role of the FREE ASPIRE in the management of the secretions in patients affected by cerebral palsy and its impact in use of health care resources. ERCA-JVD Lyon March 2015

M. D'Andria1, E. D?amanzio1, L. Cavanna2, G. Patrizio3, M. Cattoni4, C. Sampietro4, A. Imperatori4, L. Dominioni4, N. Rotolo4 Free Aspire versus PEP bottle in the tracheobronchial secretion removal in patients undergoing pulmonary lebectomy: a preliminary prospective and randomized study on 50 patients. ERCA-JVD Lyon March 2015

Cavicchioli P, Vagheggini G, Panailt E, Mazzoleni S, Montagnani G, Reitano S, Ambrosino N. Free-Aspire and chestphysiotherapy in bronchialhypersecretion. 4thERCA - Oral presentation -Barcelona- 2012

Mandalà G, Martorana M, Palermo A, La Mantia V, Progetto riabilitativo individuale nella Disfagia: valutazione funzionale strumentale e revisione della letteratura. Giorn. It. Med. Riab. Vol.34 n.3 Springer healthcare communications.

Mandalà G, La Mantia V, Sanguedolce G, Martorana M, Scaccianoce G, Sorrentino A, D’Abrosca F.Expiratory Flow Accelerator for dysphagic non cooperative patients: A pilot study for preventing aspiration pneumonia. Microbiology & infectious disease. Volume 7, Issue 2, 2023 ISSN 2639-9458

Brooks M, McLaughlin E, Shields N. Expiratory muscle strength training improves swallowing and respiratory outcomes in people with dysphagia: A systematic review. Int J Speech Lang Pathol. 2019;21:89–100.

Yoon H-Y, Shim SS, Kim SJ, Lee JH, Chang JH, Lee SH, et al. Long-Term Mortality and Prognostic Factors in Aspiration Pneumonia. J Am Med Dir Assoc. 2019;20:1098–1104.e4.

Bertelli L, Di Nardo G, Cazzato S, Ricci G, Pession A. Free-Aspire: A new device for the management of airways clearance in patient with ineffective cough. Pediatr Rep. 2017;9.

Belli S, Cattaneo D, D'Abrosca F, Prince I, Savio G, Balbi B. A pilot study on the non‐invasive management of tracheobronchial secretions in tracheostomised patients. The Clinical Respiratory Journal. 2019;13:637–42.

Santos KWD, Scheeren B, Maciel AC, Cassol M. Vocal Variability Post Swallowing in Individuals with and without Oropharyngeal Dysphagia. Int Arch Otorhinolaryngol. 2015;19:61–6.

Espitalier F, Fanous A, Aviv J, Bassiouny S, Desuter G, Nerurkar N, et al. International consensus (ICON) on assessment of oropharyngeal dysphagia. 2018. p. S17–S21.