Respiratory-Swallow Coordination in Cardiothoracic Surgical Patients

Study Overview
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Brief Summary
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Dysphagia (swallowing impairment) is a common complication of cardiothoracic surgery (CS). Although alterations in respiratory-swallow coordination is a known underlying pathophysiologic mechanism of dysphagia in multiple patient populations, no group has examined respiratory-swallow physiology in CS patients. The proposed study will examine respiratory-swallow physiology in CS patients and determine its association with unsafe swallowing and inferior health-related outcomes.

Detailed Description
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The proposed study will examine respiratory-swallow physiology in cardiothoracic surgical patients and determine its association with unsafe swallowing and inferior health-related outcomes. Participation will involve a single postoperative research exam of approximately 60-90 minute duration. Participants will be seated upright and positioned for simultaneous instrumental imaging of swallow physiology, nasal airflow monitoring, and respiratory inductance plethysmography testing.

Official Title
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A Preliminary Investigation of Respiratory-Swallow Coordination in Cardiothoracic Surgical Patients

Conditions
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Thoracic Diseases, Cardiovascular Diseases

Intervention / Treatment
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* Diagnostic Test: Videofluoroscopic swallow exam with concurrent monitoring of respiratory-swallow coordination


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Adults over 18 years of age who have undergone cardiothoracic surgery at UF Health No allergies to barium Not pregnant Willing to participate in study Exclusion criteria: Individuals 18 years of age or younger Allergies to barium Pregnant Not willing to participate in study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cardiothoracic surgical patients<br>Subjects will undergo one simultaneous instrumental examination of swallowing and concurrent monitoring of metrics of respiratory-swallow physiology. Research exam will be performed at bedside within Cardiac & Thoracic Intensive Care Units during their early postoperative recovery. | Diagnostic Test: Videofluoroscopic swallow exam with concurrent monitoring of respiratory-swallow coordination<br>* Participants will undergo simultaneous videofluoroscopy, nasal airflow and respiratory inductance plethysmography testing.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Penetration Aspiration Scale | This scale is a validated measure used by trained blinded clinicians to assign ratings of safety to swallowing bolus trials. The development and use of an 8-point, equal-appearing interval scale (8 being best; 1 being worst) to describe penetration and aspiration events are described. Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled. | Up to 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dysphagia, Extubation, Respiratory-swallow coordination, Swallow