Modified Mondays: Swallowing with Trach and NG Tube
Trachs and ng tubes and swallowing, oh my!
We’ve all heard that the presence of ng tubes and trach will negatively impact swallowing. Here’s a beautiful example of why we can’t judge that book by its cover. Patient has BOTH an ng and a trach….and a delightfully normal swallow. This was an especially nice day, since patient had been made NPO clinically and we were able to be there to deliver the good news following the instrumental.
Here is some nice work that discusses the actual impact of ng tubes and trachs on swallowing. While the presence of an ng tube has been shown to have some effect on the timing of the swallow, there is good evidence that there is no significant difference in terms of aspiration incidence.
https://www.ncbi.nlm.nih.gov/pubmed/18373994
https://www.ncbi.nlm.nih.gov/pubmed/21810774
Looking at trachs…some excellent work showing that aspiration incidence with regard to presence of a trach was linked to the medical conditions that required the trach, not to the trach itself. Also some good (although small group) work discussing the urban legend that trachs “tether” the larynx and prohibit adequate elevation.
https://www.ncbi.nlm.nih.gov/pubmed/16086412
https://www.ncbi.nlm.nih.gov/pubmed/10764011