Development of Pyriform Sinus Suctioning Programs for Aspiration Pneumonia Prevention During the Acute Stroke

AbstractAspiration due to dysphagia is a factor associated with pneumonia during acute stroke. In such cases, it is likely that secretions in the pyriform sinuses enter the laryngeal inlet. The present study was based on the idea that it is possible to reduce aspiration pneumonia by periodically suctioning and removing such secretions (pyriform sinus suctioning), a study was conducted in a single facility. The incidence of pneumonia as a dependent variable was compared between before (control) and after (intervention group) intervention with pyriform sinus suctioning as an independent variable. With a view of unifying the quality and frequency of intervention, two programs to: initially confirm the safety of such suctioning; subsequently enhance/evaluate knowledge and skills related to the procedure (educational); and specify conditions for the implementation and criteria for determining its appropriateness (practical), were developed. The study involved 33 (mean age: 74.6  ± 12.4) and 30 (80.0 ± 8.8) control and intervention group members, respectively, 25 (83.3%) of the latter were treated with pyriform sinus suctioning for 5 days after a stroke. Pneumonia developed in 7 (21.2%) and 2 (6.7%) of the former and latter, respectively. As individuals with a Japan Coma Scale (JCS) score of III or a midline shift on head CT tend to develop pharyngeal dysphagia, the patients were also divided into 2 groups to compare the incidence of pneumonia...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

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Conclusions: Lower risk of posthospitalization mortality among blacks, relative to whites, may be associated with higher rate of hospitalizations and differences in unobserved patient acuity. Disparities for Hispanics and Asians, relative to whites, vary with the mortality measure used.
Source: Medical Care - Category: Health Management Tags: Original Articles Source Type: research
Publication date: Available online 11 January 2018Source: Respiratory Physiology &NeurobiologyAuthor(s): Ha-Kyeong Won, Sol-Ji Yoon, Woo-Jung SongAbstractCough is a physiological reflex to protect airways against aspiration, but also it is one of the most frequent problems that lead patients to seek medical care. Chronic cough is more prevalent in the elderly than younger subjects, and more challenging to manage due to frequent comorbidities and possible side effects from drug treatment. Meanwhile, cough reflex does not decrease with natural aging but is often impaired by pathologic conditions like stroke. The impairme...
Source: Respiratory Physiology and Neurobiology - Category: Respiratory Medicine Source Type: research
We describe the immunohistochemical profile of secreted and membrane-associated mucins to confirm the origin of the retention cysts from dilated excretory ducts of submucosal glands. To our knowledge, this is the first report to describe esophagitis cystica contributing to cause of death at autopsy.
Source: Human Pathology: Case Reports - Category: Pathology Source Type: research
Publication date: May 2018Source: Brain, Behavior, and Immunity, Volume 70Author(s): Raymond Shim, Connie H.Y. WongAbstractStroke is a leading contributor of death and disability around the world. Despite its recognised debilitating neurological deficits, a devastating clinical complication of surviving stroke patients that needs more attention is infection. Up to half of the patients develop infections after stroke, and a high proportion of them will die as a direct consequence. Major clinical trials that examined preventive antibiotic therapy in stroke patients have demonstrated this method of prevention is not effective...
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
ConclusionsOur assessment program was safe and effective for assessing swallowing function and for determining the appropriate diet plan.
Source: International Journal of Gerontology - Category: Geriatrics Source Type: research
Publication date: Available online 11 January 2018Source: Respiratory Physiology &NeurobiologyAuthor(s): Ha-Kyeong Won, Sol-Ji Yoon, Woo-Jung SongAbstractCough is a physiological reflex to protect airways against aspiration, but also it is one of the most frequent problems that lead patients to seek medical care. Chronic cough is more prevalent in the elderly than younger subjects, and more challenging to manage due to frequent comorbidities and possible side effects from drug treatment. Meanwhile, cough reflex does not decrease with natural aging but is often impaired by pathologic conditions like stroke. The impairme...
Source: Respiratory Physiology and Neurobiology - Category: Respiratory Medicine Source Type: research
We describe the immunohistochemical profile of secreted and membrane-associated mucins to confirm the origin of the retention cysts from dilated excretory ducts of submucosal glands. To our knowledge, this is the first report to describe esophagitis cystica contributing to cause of death at autopsy.
Source: Human Pathology: Case Reports - Category: Pathology Source Type: research
Publication date: May 2018Source: Brain, Behavior, and Immunity, Volume 70Author(s): Raymond Shim, Connie H.Y. WongAbstractStroke is a leading contributor of death and disability around the world. Despite its recognised debilitating neurological deficits, a devastating clinical complication of surviving stroke patients that needs more attention is infection. Up to half of the patients develop infections after stroke, and a high proportion of them will die as a direct consequence. Major clinical trials that examined preventive antibiotic therapy in stroke patients have demonstrated this method of prevention is not effective...
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
ConclusionsOur assessment program was safe and effective for assessing swallowing function and for determining the appropriate diet plan.
Source: International Journal of Gerontology - Category: Geriatrics Source Type: research
Abstract Sepsis is one of the ten leading causes of death in developed and developing countries. In the United States, sepsis mortality approaches that of acute myocardial infarction and exceeds deaths from stroke. Neonates and the elderly are the most vulnerable patients, with these groups suffering from the highest sepsis mortality. In both groups, many survivors respectively display serious developmental disabilities and cognitive decline. The National Institute of Health National Heart Lung and Blood Institute Panel redefined sepsis as a "severe endothelial dysfunction syndrome in response to intravascula...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
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