PMID- 25137146
OWN - NLM
STAT- MEDLINE
DCOM- 20160613
LR  - 20161126
IS  - 1539-2465 (Electronic)
IS  - 1536-0652 (Linking)
VI  - 28
IP  - 10
DP  - 2015 Dec
TI  - Reduced Endotracheal Tube Cuff Pressure to Assess Dysphagia After Anterior 
      Cervical Spine Surgery.
PG  - E552-8
LID - 10.1097/BSD.0000000000000033 [doi]
AB  - STUDY DESIGN: This was a prospective, randomized control pilot study. OBJECTIVE: 
      The aim of this study was to determine whether continuous monitoring and 
      adjustment of the endotracheal tube cuff pressure (ETTCP) to 15 mm Hg during ACSS 
      would alter the incidence of postoperative dysphagia. SUMMARY OF BACKGROUND DATA: 
      Postoperative dysphagia is a recognized potential complication of anterior 
      cervical spine surgery (ACSS). Recent findings on preventive measures suggest 
      that certain intraoperative practices may minimize this complication. METHODS: 
      Fifty patients undergoing ACSS, arthroplasty, or fusion, completed routine 
      lateral cervical preoperative plain films and questionnaires [Dysphagia 
      Disability Index (DDI), Bazaz-Yoo Dysphagia Score (BYDS), and Short Form (36) 
      Health Survey]. Patients were randomized into 2 groups: treatment group with 
      ETTCP maintained at 15 mm Hg and control group with cuff pressure monitored 
      without manipulation. Radiographs and questionnaires were obtained at 24 hours, 6 
      weeks, and 3 and 6 months postsurgery to assess soft tissue thickness and rates 
      of dysphagia. RESULTS: There were no significant differences between the groups 
      in the soft tissue thickness or questionnaire scores at any timepoint (P>0.05). 
      Within-group analysis revealed treatment and control groups had a significantly 
      higher 24-hour postoperative soft tissue thickness and questionnaire scores 
      compared with follow-up measurements (P<0.05). In the pooled group (n=50), the 
      24-hour postoperative DDI, BYDS, and soft tissue thickness were significantly 
      higher compared with all other timepoints (P<0.01). DDI scores >/=10 related to 
      dysphagia were in 59% of patients at 24 hours, 35% at 6 weeks, 24% at 3 months, 
      and 18% at 6 months. CONCLUSIONS: This study suggests decreased ETTCP has no 
      effect on the prevalence of dysphagia. The incidence of dysphagia decreases over 
      time and normalizes by 6 months postsurgery.
FAU - Kowalczyk, Izabela
AU  - Kowalczyk I
AD  - *Department of Medical Biophysics daggerCentre for Functional and Metabolic Mapping, 
      Robarts Research Institute, Western University double daggerDepartment of Clinical 
      Neurological Sciences; Neurosurgery, University Hospital, London Health Sciences 
      Centre, London, ON, Canada  section signSt. Luke's Neurosurgical Associates, Bethlehem, PA 
       parallelDepartment of Anesthesiology, University Hospital, London Health Sciences 
      Centre, London, ON, Canada.
FAU - Ryu, Won Hyung A
AU  - Ryu WH
FAU - Rabin, Doron
AU  - Rabin D
FAU - Arango, Miguel
AU  - Arango M
FAU - Duggal, Neil
AU  - Duggal N
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Spinal Disord Tech
JT  - Journal of spinal disorders & techniques
JID - 101140323
SB  - IM
MH  - Adult
MH  - Aged
MH  - Case-Control Studies
MH  - Cervical Vertebrae/diagnostic imaging/*surgery
MH  - Deglutition Disorders/*diagnosis/diagnostic imaging/*etiology
MH  - Disability Evaluation
MH  - Female
MH  - Humans
MH  - *Intubation, Intratracheal
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*etiology
MH  - *Pressure
MH  - Radiography
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
EDAT- 2014/08/20 06:00
MHDA- 2016/06/14 06:00
CRDT- 2014/08/20 06:00
PHST- 2014/08/20 06:00 [entrez]
PHST- 2014/08/20 06:00 [pubmed]
PHST- 2016/06/14 06:00 [medline]
AID - 10.1097/BSD.0000000000000033 [doi]
PST - ppublish
SO  - J Spinal Disord Tech. 2015 Dec;28(10):E552-8. doi: 10.1097/BSD.0000000000000033.