Pulse oximetry monitoring for the evaluation of swallowing function

Abstract

The aim of this study was to investigate the relationship between aspiration and oxygen desaturation and to assess the efficacy of using pulse oximetry monitoring as a clinical tool to predict or detect aspiration. The 204 subjects were divided into four groups: 63 control subjects, 110 dysphagics, 9 dysphagics with a cuffed tracheostomy tube and 22 laryngectomized subjects. Arterial oxygen saturation (SpO2) was continuously measured throughout fluorographic examination until an adequate post-examination period afterward. Then, fluorographic findings (aspiration) and SpO2 levels were compared. Eighty-five percent of aspirators showed SpO2 declines of 2% or more during swallowing procedures, but, conversely, aspiration could not be predicted or detected by an SpO2 decline because of low sensitivity and specificity (84.6% and 82.5%, respectively). SpO2 declines were also seen in laryngectomized subjects and non-aspirators with breath-holding. One patient with a cuffed tracheostomy tube showed a transient elevation of SpO2 following aspiration. In conclusion, aspirators show a SpO2 decline during swallowing procedures, but POM is not useful to predict or detect aspiration. Other events, such as breath-holding, posture change, coughing and compromised pulmonary functioning, may be related to oxygen desaturation.