The Interaction of Pulmonary Physiology and Swallowing: A Juggling Act for the Physician and Speech-Language Pathologist Patients who are dependent upon tracheostomy and/or ventilator use present a particular challenge to health-care providers. The interaction of pulmonary physiology and deglutition is complex, as illustrated in the course of patients who are in the weaning process. Speech language pathologists (SLPs) should work closely with their physician colleagues to ... Article
Article  |   March 2009
The Interaction of Pulmonary Physiology and Swallowing: A Juggling Act for the Physician and Speech-Language Pathologist
Author Affiliations & Notes
  • Karen J. Dikeman
    Department of Speech Pathology, The Silvercrest Center for Nursing and Rehabilitation and New York Hospital Queens, Queens, NY
  • Marta S. Kazandjian
    Department of Speech Pathology, The Silvercrest Center for Nursing and Rehabilitation and New York Hospital Queens, Queens, NY
  • Elbert Tun
    Medical Services, The Silvercrest Center for Nursing and Rehabilitation and New York Hospital Queens, Queens, NY
  • Panina Niyazova
    Medical Services, The Silvercrest Center for Nursing and Rehabilitation and New York Hospital Queens, Queens, NY
  • Tien-Tsai Tsai
    Medical Services, The Silvercrest Center for Nursing and Rehabilitation and New York Hospital Queens, Queens, NY
  • Daniel J. Russo
    Medical Services, The Silvercrest Center for Nursing and Rehabilitation and New York Hospital Queens, Queens, NY
  • Copyright © 2009 American Speech-Language-Hearing Association
Article Information
Swallowing, Dysphagia & Feeding Disorders / Articles
Article   |   March 2009
The Interaction of Pulmonary Physiology and Swallowing: A Juggling Act for the Physician and Speech-Language Pathologist
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), March 2009, Vol. 18, 34-40. doi:10.1044/sasd18.1.34
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), March 2009, Vol. 18, 34-40. doi:10.1044/sasd18.1.34
The authors acknowledge the work of their colleagues Claudia Giammarino, Leeanne Robison and Lisa Adams with the challenging case presentations described in this article.
Abstract

Patients who are dependent upon tracheostomy and/or ventilator use present a particular challenge to health-care providers. The interaction of pulmonary physiology and deglutition is complex, as illustrated in the course of patients who are in the weaning process. Speech language pathologists (SLPs) should work closely with their physician colleagues to understand the influence of multiple medical co-morbidities on intervention. In traditional medicine, the clinician's objective is to connect a patient's many symptoms and complaints to a single disease entity. However, in caring for the ventilator dependent geriatric population, a symptom such as dysphagia typically results from the interplay of various, multi-organ symptoms, and conditions. This article strives to demonstrate the “juggling act” that the physician and SLP must balance between the patient's current medical condition, pulmonary dysfunction, and disordered swallowing. Clinical case studies illustrate the benefit of swallowing intervention on quality of life. While the care of patients with tracheostomy and ventilator dependence requires a team approach, with respiratory therapy and nursing vital members, this article emphasizes the roles of the SLP and physician.

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