The Effect of Nasogastric Tubes on Swallowing Function in Persons With Dysphagia Following Stroke

Wang T-G, Wu M-C, Chang Y-C, Hsiao T-Y, Lien I-N. The effect of nasogastric tubes on swallowing function in persons with dysphagia following stroke.ObjectiveTo determine whether the use of a nasogastric tube influences swallowing function in stroke patients with dysphagia.DesignBefore-after trial.SettingPrimary care center.ParticipantsA total of 22 patients with stroke (12 men, 10 women; mean age, 69.7y; range, 19−85y) participated in the study. Time from onset of stroke to time of assessment averaged 20.3 days (range, 14−38d). All participants continued to use a nasogastric tube for nutrition supply and had either minor or no aspiration of barium on videofluoroscopic examination of swallowing (VFES).InterventionThe swallowing function was evaluated by VFES with thin and thick bariums (5mL each) as a contrast medium.Main Outcome MeasuresThe oral transit, swallowing trigger, and pharyngeal transit times were measured and compared before and after the removal of the nasogastric tube. The patients were also observed for changes in velopharyngeal closure, pharyngeal contraction, epiglottic tilt, valleculae stasis, pyriform sinus stasis, penetration, and aspiration.ResultsTransit times were reduced by 0.2 to 0.6 seconds after removal of the nasogastric tube, but the reduction was not statistically significant. These transit times were slightly longer with thick barium than with thin barium, but were without statistical significance. Similarly, most of the patients had no change in nontemporal assessment of swallowing function after the tube was removed.ConclusionsThe placement of a nasogastric tube did not affect temporal and nontemporal measurement of swallowing in stroke patients with dysphagia with or without minor aspiration.