Trans esophageal echocardiography increases dysphagia risk in stroke patients: Study
Germany: Transesophageal echocardiography (TEE) has a detrimental effect on swallowing in acute stroke patients for at least 24 hours, according to a recent study in the European Journal of Neurology.
Dysphagia (difficulty in swallowing) is common among stroke patients and is associated with worse overall outcomes. TEE is used in the diagnostic evaluation of stroke and is known to cause postoperative dysphagia in cardiac surgery. The prevalence of dysphagia is unknown in acute stroke patients undergoing TEE.
The aim of the Transesophageal Echocardiography – Dysphagia Risk in Acute Stroke (TEDRAS) study by S. Hamzic, Justus‐Liebig‐University, Giessen, Germany, and colleagues was to assess the influence of TEE on swallowing among patients who have experienced acute stroke.
The study included a total of 34 patients with acute stroke. 18 were randomized to the intervention group and 15 to the control group.
Swallowing was tested using flexible endoscopic evaluation of swallowing (FEES) at three different time points in the intervention group (24 h before, immediately after and 24 h after TEE) and in the control group (FEES on three consecutive days and TEE earliest after the third FEES). Validated scales were used to assess dysphagia severity for all time points as primary outcome measures.
The key findings of the repeated‐measures between‐group comparisons were significant increases in the intervention group for the following dysphagia measures: (1) secretion severity score and (2) Penetration‐Aspiration Scale score for saliva for the small and large liquid boil.
"The results indicate a negative influence of TEE on swallowing in acute stroke patients for at least 24 hours," concluded the authors.
"Transesophageal Echocardiography – Dysphagia Risk in Acute Stroke (TEDRAS): a prospective, blind, randomized and controlled clinical trial," is published in the European Journal of Neurology.