PDF(Pubmed)
Abstract：
BACKGROUND: Dysphagia occurs in multiple respiratory pathophysiologies, increasing the risk of pulmonary complications secondary to aspiration. Reflux associated aspiration and a dysregulated lung microbiome is implicated in Idiopathic Pulmonary Fibrosis (IPF), but swallowing dysfunction has not been described. We aimed to explore oropharyngeal swallowing in IPF patients, without known swallowing dysfunction.
METHODS: Fourteen consecutive outpatients with a secure diagnosis of IPF were recruited and the 10-item Eating Assessment Tool (Eat 10) used to assess patient perception of swallowing difficulty. Oropharyngeal swallowing was assessed in ten patients using Videofluoroscopy Swallow Studies (VFSS). The studies were rated using validated scales: Penetration-Aspiration Scale (PAS); standardised Modified Barium Swallow Impairment Profile (MBSImP).
RESULTS: EAT-10 scores indicated frank swallowing difficulty in 4/14 patients. Videofluoroscopy Studies showed that 3/10 patients had airway penetration, and one aspirated liquid without a cough response. Median MBSImp for oral impairment was 5, range [3-7] and pharyngeal impairment 4, range [1-14] indicating, overall mild alteration to swallowing physiology.
CONCLUSIONS: We conclude that people with IPF can show a range of swallowing dysfunction, including aspiration into an unprotected airway. To our knowledge, this is the first report on swallowing physiology and safety in IPF. We believe a proportion of this group may be at risk of aspiration. Further work is indicated to fully explore swallowing in this vulnerable group.
METHODS: Fourteen consecutive outpatients with a secure diagnosis of IPF were recruited and the 10-item Eating Assessment Tool (Eat 10) used to assess patient perception of swallowing difficulty. Oropharyngeal swallowing was assessed in ten patients using Videofluoroscopy Swallow Studies (VFSS). The studies were rated using validated scales: Penetration-Aspiration Scale (PAS); standardised Modified Barium Swallow Impairment Profile (MBSImP).
RESULTS: EAT-10 scores indicated frank swallowing difficulty in 4/14 patients. Videofluoroscopy Studies showed that 3/10 patients had airway penetration, and one aspirated liquid without a cough response. Median MBSImp for oral impairment was 5, range [3-7] and pharyngeal impairment 4, range [1-14] indicating, overall mild alteration to swallowing physiology.
CONCLUSIONS: We conclude that people with IPF can show a range of swallowing dysfunction, including aspiration into an unprotected airway. To our knowledge, this is the first report on swallowing physiology and safety in IPF. We believe a proportion of this group may be at risk of aspiration. Further work is indicated to fully explore swallowing in this vulnerable group.
摘要：
背景：吞咽困难发生在多种呼吸道病理生理中，增加继发于误吸的肺部并发症的风险。反流相关的误吸和肺微生物组失调与特发性肺纤维化（IPF）有关，但吞咽功能障碍尚未被描述。我们旨在探索IPF患者的口咽吞咽，没有已知的吞咽功能障碍。
方法：招募了14例确诊为IPF的连续门诊患者，并使用10项饮食评估工具（Eat10）评估患者对吞咽困难的感知。使用透视吞咽研究（VFSS）评估了10例患者的口咽吞咽。使用经过验证的量表对研究进行了评估：穿透-抽吸量表（PAS）；标准化的修改后的钡吞咽损伤谱（MBSIMP）。
结果：EAT-10评分显示4/14例患者有明显吞咽困难。视频透视研究显示，3/10的患者有气道穿透，和一个没有咳嗽反应的液体。口腔损害的MBSImp中位数为5，范围为[3-7]，咽部损害为4，范围为[1-14]，表明吞咽生理的总体轻度改变。
结论：我们得出结论，IPF患者可以表现出一系列吞咽功能障碍，包括吸入无保护的气道。据我们所知,这是关于IPF吞咽生理和安全性的第一份报告.我们认为，这一群体中的一部分人可能有抱负的风险。指出了进一步的工作，以充分探索这一弱势群体的吞咽行为。
方法：招募了14例确诊为IPF的连续门诊患者，并使用10项饮食评估工具（Eat10）评估患者对吞咽困难的感知。使用透视吞咽研究（VFSS）评估了10例患者的口咽吞咽。使用经过验证的量表对研究进行了评估：穿透-抽吸量表（PAS）；标准化的修改后的钡吞咽损伤谱（MBSIMP）。
结果：EAT-10评分显示4/14例患者有明显吞咽困难。视频透视研究显示，3/10的患者有气道穿透，和一个没有咳嗽反应的液体。口腔损害的MBSImp中位数为5，范围为[3-7]，咽部损害为4，范围为[1-14]，表明吞咽生理的总体轻度改变。
结论：我们得出结论，IPF患者可以表现出一系列吞咽功能障碍，包括吸入无保护的气道。据我们所知,这是关于IPF吞咽生理和安全性的第一份报告.我们认为，这一群体中的一部分人可能有抱负的风险。指出了进一步的工作，以充分探索这一弱势群体的吞咽行为。
