Pharyngeal Electrical Stimulation Effective for Post-Stroke Dysphagia After Tracheotomy
A higher percentage of PES-treated participants were ready for decannulation compared with those assigned to sham control.
Pharyngeal electrical stimulation (PES) could be an effective method for improving swallowing in patients with post-stroke dysphagia who have undergone tracheotomy. The study was published in The Lancet Neurology.
This international, multisite, prospective, single-blind, sham-controlled study researched the effect of PES on both primary and secondary outcomes. The study population (N=69) was randomly assigned into PES treatment (n=35) or sham control (n=34); all participants were involved in the open-label portion. Study demographics were as follows: 36% female; mean age, 64.2 years old (SD 11.9); 71% had experienced an ischemic stroke, and 29% had had an intracerebral hemorrhage.
Findings from the randomized portion of the study showed a higher percentage of PES-treated participants (49%, P =.00082) were ready for decannulation compared with those assigned to sham control; 82% of PES-treated patients were decannulated with no recannulation necessary. Findings from the open-label study showed no decannulated PES-treated participants remained. Of the sham control population treated with PES, 53% were ready for de-cannulation at the specified period. There were adverse events noted in both PES and sham arms. Dysphagia scores differed between groups in favor of the treatment responders.
Study limitations include the small sample size, study bias due to the single-blind approach of PES delivery, and open-label participation inclusion parameters.
Taken together, the results suggest that in comparison to sham control, PES was “safe and superior” for improving airway protection and swallowing in patients with severe post-stroke dysphagia who underwent tracheotomy.
Disclosures: This study was funded by Phagenesis Ltd. Please refer to original reference for a full list of authors' disclosures.
Dziewas R, Stellato R, van der Tweel I, et al. Pharyngeal electrical stimulation for early decannulation in tracheotomised patients with neurogenic dysphagia after stroke (PHAST-TRAC): a prospective, single-blinded, randomized trial [Published online August 28, 2018]. Lancet Neurol. doi: 10.1016S1474-4422(18)30255-2