Can pulse oximetry or a bedside swallowing assessment be used to detect aspiration after stroke?

Abstract:

BACKGROUND AND PURPOSE:Desaturation during swallowing may help to identify aspiration in stroke patients. This study investigated pulse oximetry, bedside swallowing assessment (BSA), and videofluoroscopy as tests for detecting aspiration after stroke. METHODS:Swallowing was assessed in 189 stroke patients (mean+/-SD age, 70.9+/-12.3 years) within 5 days of symptom onset with a modified BSA (water replaced by radio-opaque contrast agent, followed by chest radiography to detect aspiration). Simultaneous pulse oximetry recorded the greatest desaturation from baseline for 10 minutes from modified BSA onset. Videofluoroscopy was undertaken in 54 (28%) patients. RESULTS:Modified BSA showed a safe swallow in 98 (51.9%), unsafe swallow in 85 (45.0%), and silent aspiration in 6 (3.2%) patients. During swallowing, desaturation by >2% occurred in 27 (27.6%) and by >5% in 3 (3.1%) of the 98 safe-swallow patients on modified BSA. Of the 85 unsafe-swallow patients, only 28 (32.9%) desaturated by >2% and 6 (7.1%) by >5%. Desaturation did not occur in any of the 6 silent aspirators. With the modified BSA to detect aspiration, sensitivity and specificity, respectively, were 0.31 and 0.72 for desaturation >2% and 0.07 and 0.97 for desaturation >5%. By videofluoroscopy, sensitivity and specificity for detecting aspiration were 0.47 and 0.72 for modified BSA, 0.33 and 0.62 for desaturation >2%, and 0.13 and 0.95 for desaturation >5%. Combining a failed modified BSA with desaturation >2% or >5% did not significantly improve predictive values. CONCLUSIONS:Modified BSA and pulse oximetry during swallowing, whether alone or in combination, showed inadequate sensitivity, specificity, and predictive values for detection of aspiration compared with videofluoroscopy in stroke patients.

journal_name

Stroke

journal_title

Stroke

authors

Ramsey DJ,Smithard DG,Kalra L

doi

10.1161/01.STR.0000248758.32627.3b

subject

Has Abstract

pub_date

2006-12-01 00:00:00

pages

2984-8

issue

12

eissn

0039-2499

issn

1524-4628

pii

01.STR.0000248758.32627.3b

journal_volume

37

pub_type

杂志文章

相关文献

STROKE文献大全
  • Does hemispheric lateralization influence functional and cardiovascular outcomes after stroke?: an analysis of placebo-treated patients from prospective acute stroke trials.

    abstract:BACKGROUND AND PURPOSE:The influence of stroke lateralization on functional and cardiovascular outcome after stroke is not well established. We evaluated the influence of hemispheric lateralization among patients enrolled in prospective acute stroke trials. METHODS:We obtained data from the VISTA database for acute st...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.108.523365

    authors: Fink JN,Frampton CM,Lyden P,Lees KR,Virtual International Stroke Trials Archive Investigators.

    更新日期:2008-12-01 00:00:00

  • Trends in Stroke Recurrence in Mexican Americans and Non-Hispanic Whites.

    abstract:BACKGROUND AND PURPOSE:Stroke incidence and mortality are declining rapidly in developed countries. Little data on ethnic-specific stroke recurrence trends exist. Fourteen-year stroke recurrence trend estimates were evaluated in Mexican Americans and non-Hispanic whites in a population-based study. METHODS:Recurrent s...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.120.029376

    authors: Sozener CB,Lisabeth LD,Shafie-Khorassani F,Kim S,Zahuranec DB,Brown DL,Skolarus LE,Burke JF,Kerber KA,Meurer WJ,Case E,Morgenstern LB

    更新日期:2020-08-01 00:00:00

  • Cerebrovascular disease in Utah, 1968--1971.

    abstract::Utah mortality rates for cerebrovascular disease (ICD numbers 430--438) are 13% below U.S. rates. About 70% of Utahns are members of the Church of Jesus Christ of Latter-day Saints, commonly called Mormons of LDS, which proscribes use of tobacco and alcohol. Other studies on this group have found significantly lower o...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.12.5.564

    authors: Lyon JL,Bishop CT,Nielsen NS

    更新日期:1981-09-01 00:00:00

  • Candesartan augments ischemia-induced proangiogenic state and results in sustained improvement after stroke.

    abstract:BACKGROUND AND PURPOSE:We have shown that acute treatment with candesartan in an experimental model of stroke resulted in vascular protection and improved outcomes at 24 hours poststroke, but the mechanisms are unknown. We now examine effects of candesartan on proangiogenic factors and 7-day outcomes using the same tre...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.108.537225

    authors: Kozak A,Ergul A,El-Remessy AB,Johnson MH,Machado LS,Elewa HF,Abdelsaid M,Wiley DC,Fagan SC

    更新日期:2009-05-01 00:00:00

  • Prediction of hemorrhagic transformation after thrombolytic therapy of clot embolism: an MRI investigation in rat brain.

    abstract:BACKGROUND AND PURPOSE:Thrombolytic treatment of stroke carries the risk of hemorrhagic transformation. Therefore, the potential of MRI for prediction of recombinant tissue plasminogen activator (rtPA)-induced bleeding is explored to identify patients in whom rtPA treatment may provoke such complications. METHODS:Spon...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.0000014619.59851.65

    authors: Neumann-Haefelin C,Brinker G,Uhlenküken U,Pillekamp F,Hossmann KA,Hoehn M

    更新日期:2002-05-01 00:00:00

  • Stent-assisted coiling of intracranial aneurysms: clinical and angiographic results in 216 consecutive aneurysms.

    abstract:BACKGROUND AND PURPOSE:Stent-assisted coiling has expanded the treatment of intracranial aneurysms, but the rates of procedure-related neurological complications and the incidence of angiographic aneurysm recurrence of this novel treatment are not yet well known. We present our experience with stent-assisted coiling wi...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.109.558114

    authors: Piotin M,Blanc R,Spelle L,Mounayer C,Piantino R,Schmidt PJ,Moret J

    更新日期:2010-01-01 00:00:00

  • Optimization of Prehospital Triage of Patients With Suspected Ischemic Stroke.

    abstract::Background and Purpose- Prehospital routing algorithms for patients with suspected stroke because of large vessel occlusions should account for likelihood of benefit from endovascular therapy (EVT), risk of alteplase delays, and transport times. We built a mathematical model to give a real-time, location-based optimal...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.118.022041

    authors: Ali A,Zachrison KS,Eschenfeldt PC,Schwamm LH,Hur C

    更新日期:2018-10-01 00:00:00

  • Transesophageal echocardiography in the detection of potential cardiac source of embolism in stroke patients.

    abstract::To compare the diagnostic yields of transesophageal and transthoracic echocardiography in the detection of potential cardiac sources of embolism, 63 patients (mean +/- SD age 63 +/- 15 [range 18-87] years) with transient ischemic attacks or stroke underwent both procedures. Transthoracic echocardiography revealed a po...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.22.6.727

    authors: Cujec B,Polasek P,Voll C,Shuaib A

    更新日期:1991-06-01 00:00:00

  • Effect of Fluosol on oxygen availability, regional cerebral blood flow, and infarct size in a model of temporary focal cerebral ischemia.

    abstract::Twenty-four cats had an intravenous infusion of either Fluosol or saline and then were subjected to 2 hours of middle cerebral artery occlusion. All the animals infused with Fluosol and one-half the animals infused with saline were ventilated with 100% O2. Tissue oxygen availability and regional cerebral blood flow we...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.17.5.976

    authors: Kolluri S,Heros RC,Hedley-Whyte ET,Vonsattel JP,Miller D,Zervas NT

    更新日期:1986-09-01 00:00:00

  • Comparative effectiveness of unruptured cerebral aneurysm therapies: propensity score analysis of clipping versus coiling.

    abstract:BACKGROUND AND PURPOSE:Endovascular therapy has increasingly become the most common treatment for unruptured cerebral aneurysms in the United States. We evaluated a national, multi-hospital database to examine recent utilization trends and compare periprocedural outcomes between clipping and coiling treatments of unrup...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.111.000196

    authors: McDonald JS,McDonald RJ,Fan J,Kallmes DF,Lanzino G,Cloft HJ

    更新日期:2013-04-01 00:00:00

  • The effect of a thromboxane synthetase inhibitor, OKY-046, on urinary excretion of immunoreactive thromboxane B2 and 6-keto-prostaglandin F1 alpha in patients with ischemic cerebrovascular disease.

    abstract::Thromboxane synthetase activity is selectively inhibited by (E)-3-[4-(1-imidazolylmethyl)phenyl]-2-propenoic acid hydrochloride monohydrate (OKY-046). A single dose of 100 mg OKY-046 was orally administered to patients with ischemic cerebrovascular disease and healthy volunteers. Platelet aggregation and thromboxane B...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.16.2.241

    authors: Uyama O,Nagatsuka K,Nakabayashi S,Isaka Y,Yoneda S,Kimura K,Abe H

    更新日期:1985-03-01 00:00:00

  • Remodeling of the corticospinal innervation and spontaneous behavioral recovery after ischemic stroke in adult mice.

    abstract:BACKGROUND AND PURPOSE:To elucidate how the motor pathways rewire the denervated tissue after stroke, we investigated remodeling of the corticospinal tract (CST) in transgenic mice with yellow fluorescent protein CST labeling in conjunction with transsynaptic pseudorabies virus retrograde tracing. METHODS:Adult male C...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.109.547265

    authors: Liu Z,Zhang RL,Li Y,Cui Y,Chopp M

    更新日期:2009-07-01 00:00:00

  • Molecular basis for the inhibition of prostanoid biosynthesis by nonsteroidal anti-inflammatory agents.

    abstract::Many nonsteroidal anti-inflammatory drugs exert their effects by inhibiting the synthesis of prostanoids. More specifically, these agents block the synthesis of prostaglandin endoperoxide G2 from arachidonic acid by competing with arachidonate for binding to the cyclooxygenase active site of prostaglandin endoperoxide...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:

    authors: Smith WL,DeWitt DL,Shimokawa T,Kraemer SA,Meade EA

    更新日期:1990-12-01 00:00:00

  • Endogenous dopamine amplifies ischemic long-term potentiation via D1 receptors.

    abstract:BACKGROUND AND PURPOSE:Several observations indicate that, during energy deprivation, endogenous dopamine may become neurotoxic. Accordingly, the nucleus striatum is a preferential site of silent infarcts in humans, and experimental ischemia caused by homolateral carotid occlusion selectively damages this dopamine-enri...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.0000038093.42512.0f

    authors: Saulle E,Centonze D,Martín AB,Moratalla R,Bernardi G,Calabresi P

    更新日期:2002-12-01 00:00:00

  • MRI-based separation of congenital and acquired vertebrobasilar artery anomalies in ischemic stroke of the posterior circulation.

    abstract:BACKGROUND AND PURPOSE:Stroke MRI protocols provide useful information about underlying vessel pathologies in the anterior circulation by means of intracranial time-of-flight angiography. However, these protocols mostly fail in the posterior circulation to differentiate between congenital variants and secondary thrombo...

    journal_title:Stroke

    pub_type: 信件

    doi:10.1161/STROKEAHA.107.512772

    authors: Freund W,Kassubek J,Aschoff AJ,Huber R

    更新日期:2008-08-01 00:00:00

  • Stent placement in acute cerebral artery occlusion: use of a self-expandable intracranial stent for acute stroke treatment.

    abstract:BACKGROUND AND PURPOSE:Stent placement has been applied in small case series as a rescue therapy in combination with different thrombolytic agents, percutaneous balloon angioplasty (PTA), and mechanical thromboembolectomy (MT) in acute stroke treatment. These studies report a considerable mortality and a high rate of i...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.108.533810

    authors: Brekenfeld C,Schroth G,Mattle HP,Do DD,Remonda L,Mordasini P,Arnold M,Nedeltchev K,Meier N,Gralla J

    更新日期:2009-03-01 00:00:00

  • Stroke, statins, and cholesterol. A meta-analysis of randomized, placebo-controlled, double-blind trials with HMG-CoA reductase inhibitors.

    abstract:BACKGROUND AND PURPOSE:To estimate the effect of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors ("statins") on stroke ris, we combined the data of the randomized, placebo-controlled, double-blind trials with HMG-CoA reductase inhibitors published so far. METHODS:The studies were identified using ...

    journal_title:Stroke

    pub_type: 杂志文章,meta分析

    doi:10.1161/01.str.28.5.946

    authors: Blauw GJ,Lagaay AM,Smelt AH,Westendorp RG

    更新日期:1997-05-01 00:00:00

  • Overlap of diseases underlying ischemic stroke: the ASCOD phenotyping.

    abstract:BACKGROUND AND PURPOSE:ASCOD phenotyping (A, atherosclerosis; S, small vessel disease; C, cardiac pathology; O, other causes; and D, dissection) assigns a degree of likelihood to every potential cause (1 for potentially causal, 2 for causality is uncertain, 3 for unlikely causal but disease is present, 0 for absence of...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.113.001363

    authors: Sirimarco G,Lavallée PC,Labreuche J,Meseguer E,Cabrejo L,Guidoux C,Klein IF,Olivot JM,Abboud H,Adraï V,Kusmierek J,Ratani S,Touboul PJ,Mazighi M,Steg PG,Amarenco P

    更新日期:2013-09-01 00:00:00

  • Mobile Stroke Unit Computed Tomography Angiography Substantially Shortens Door-to-Puncture Time.

    abstract::Background and Purpose- Endovascular thrombectomy (ET) door-to-puncture time (DTPT) is a modifiable metric. One of the most important, yet time-consuming steps, is documentation of large vessel occlusion by computed tomography angiography (CTA). We hypothesized that obtaining CTA on board a Mobile Stroke Unit and dire...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.119.028626

    authors: Czap AL,Singh N,Bowry R,Jagolino-Cole A,Parker SA,Phan K,Wang M,Sheth SA,Rajan SS,Yamal JM,Grotta JC

    更新日期:2020-05-01 00:00:00

  • Effects of hypothermia on evoked potentials, magnetic resonance imaging, and blood flow in focal ischemia in rabbits.

    abstract:BACKGROUND AND PURPOSE:Mild hypothermia has been shown to ameliorate neuronal damage due to cerebral ischemia. In our study, the influence of mild-to-moderate hypothermia was examined in a rabbit model of focal cerebral ischemia. METHODS:After 4 hours of permanent ischemia induced by occlusion of the anterior and midd...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.23.6.889

    authors: Lo EH,Steinberg GK

    更新日期:1992-06-01 00:00:00

  • Midazolam challenge reinduces neurological deficits after transient ischemic attack.

    abstract:BACKGROUND AND PURPOSE:A transient ischemic attack (TIA) in the brain is classically considered a syndrome lasting <24 hours. Having previously shown that an experimental challenge with the GABAA agonist midazolam in recovered stroke patients can reinduce the acute clinical state, we determined whether TIA patients wou...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.STR.0000056540.04159.F3

    authors: Lazar RM,Fitzsimmons BF,Marshall RS,Mohr JP,Berman MF

    更新日期:2003-03-01 00:00:00

  • Compliance with antiplatelet therapy in patients with ischemic cerebrovascular disease. Assessment by platelet aggregation testing.

    abstract:BACKGROUND AND PURPOSE:Antiplatelet therapy is currently one of the methods for preventing transient ischemic attacks and cerebral thrombosis. Because antiplatelet agents are generally administered on a long-term basis, patient compliance is an important factor. The purpose of this study was to determine the compliance...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.str.25.12.2337

    authors: Komiya T,Kudo M,Urabe T,Mizuno Y

    更新日期:1994-12-01 00:00:00

  • Mouse model of microembolic stroke and reperfusion.

    abstract:BACKGROUND AND PURPOSE:To test the role of fibrinolysis in stroke, we used a mouse model in which preformed 2.5- to 3-microm-diameter fibrin microemboli are injected into the cerebral circulation. The microemboli lodge in the downstream precapillary vasculature and are susceptible to fibrinolysis. METHODS:We injected ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000137412.35700.0e

    authors: Atochin DN,Murciano JC,Gürsoy-Ozdemir Y,Krasik T,Noda F,Ayata C,Dunn AK,Moskowitz MA,Huang PL,Muzykantov VR

    更新日期:2004-09-01 00:00:00

  • Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral Artery (DESTINY): a randomized, controlled trial.

    abstract:BACKGROUND AND PURPOSE:Decompressive surgery (hemicraniectomy) for life-threatening massive cerebral infarction represents a controversial issue in neurocritical care medicine. We report here the 30-day mortality and 6- and 12-month functional outcomes from the DESTINY trial. METHODS:DESTINY (ISRCTN01258591) is a pros...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/STROKEAHA.107.485649

    authors: Jüttler E,Schwab S,Schmiedek P,Unterberg A,Hennerici M,Woitzik J,Witte S,Jenetzky E,Hacke W,DESTINY Study Group.

    更新日期:2007-09-01 00:00:00

  • Effect of dietary modification on incident carotid artery disease in postmenopausal women: results from the women's health initiative dietary modification trial.

    abstract:BACKGROUND AND PURPOSE:Because the diagnosis and treatment of carotid artery disease may reduce the rate of stroke, the aim of this study was to determine whether a diet intervention was associated with incident carotid artery disease. METHODS:Participants were 48 835 postmenopausal women aged 50 to 79 years who were ...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/STROKEAHA.114.005096

    authors: Allison MA,Aragaki A,Eaton C,Li W,Van Horn L,Daviglus ML,Berger JS

    更新日期:2014-06-01 00:00:00

  • The deleterious or beneficial effects of different agents in intracerebral hemorrhage: think big, think small, or is hematoma size important?

    abstract:BACKGROUND AND PURPOSE:Thrombin, heme oxygenase, complement, microglia activation, and leukocyte infiltration are all actively upregulated in intracerebral hemorrhage (ICH). Experimental evidence suggests that all these factors are involved in ICH-induced brain injury. This suggests a scenario whereby ICH actively (thr...

    journal_title:Stroke

    pub_type: 杂志文章,评审

    doi:10.1161/01.STR.0000170701.41507.e1

    authors: Keep RF,Xi G,Hua Y,Hoff JT

    更新日期:2005-07-01 00:00:00

  • Fatal infantile polyarteritis nodosa with predominant central nervous system involvement.

    abstract:BACKGROUND:Infantile polyarteritis nodosa usually presents in children under 2 years of age as a multiorgan system disease with signs of congestive heart failure or renal failure. This disease and Kawasaki disease may share certain clinical and pathological features. CASE DESCRIPTION:We describe a child who first pres...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.26.4.699

    authors: Engel DG,Gospe SM Jr,Tracy KA,Ellis WG,Lie JT

    更新日期:1995-04-01 00:00:00

  • Is there a direct link between cerebrovascular activity and cerebrospinal fluid pressure-volume compensation?

    abstract:BACKGROUND AND PURPOSE:Cerebral blood flow is coupled to brain metabolism by means of active modulation of cerebrovascular resistance. This homeostatic vasogenic activity is reflected in slow waves of cerebral blood flow velocities (FV) which can also be detected in intracranial pressure (ICP). However, effects of incr...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.485847

    authors: Haubrich C,Czosnyka Z,Lavinio A,Smielewski P,Diehl RR,Pickard JD,Czosnyka M

    更新日期:2007-10-01 00:00:00

  • Blood Pressure Variability and Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis of Population-Based Cohorts.

    abstract::Background and Purpose- Blood pressure (BP) variability may increase the risk of stroke and dementia. It remains inconclusive whether BP variability is associated with cerebral small vessel disease, a common and potentially devastating subclinical disease that contributes significantly to both stroke and dementia. Met...

    journal_title:Stroke

    pub_type: 杂志文章,meta分析

    doi:10.1161/STROKEAHA.119.026739

    authors: Ma Y,Song A,Viswanathan A,Blacker D,Vernooij MW,Hofman A,Papatheodorou S

    更新日期:2020-01-01 00:00:00

  • Mobile aortic plaques are a cause of multiple brain infarcts seen on diffusion-weighted imaging.

    abstract:BACKGROUND AND PURPOSE:Multiple brain infarcts are often seen on diffusion-weighted images in cardioembolic stroke patients. Recently, mobile aortic plaques (MAPs) have been proposed as embolic sources. However, the clinical characteristics of patients with MAPs are unclear. METHODS:We prospectively studied patients w...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.482497

    authors: Ueno Y,Kimura K,Iguchi Y,Shibazaki K,Inoue T,Hattori N,Urabe T

    更新日期:2007-09-01 00:00:00