Initiation of Oral Intake in Patients Using High-Flow Nasal Cannula: A Retrospective Analysis

Purpose High-flow nasal cannula (HFNC) is beneficial for critically ill patients in respiratory distress. Because the effects of HFNC on swallowing are unclear, speech-language pathologists lack the research to support evidence-based clinical decision making. We hypothesize that multiple factors contribute to a patient's readiness for oral alimentation while on HFNC. This retrospective analysis puts forth clinically relevant observations from a patient population on HFNC and considerations in clinical decision making about initiation of safe oral alimentation. Method Retrospective data were gathered for all patients who underwent a modified barium swallow study (MBSS) while on HFNC during hospital admission between January 2015 and March 2018. Data included demographics, medical history, oxygen settings, cognitive status, Modified Barium Swallow Impairment Profile scores, Penetration–Aspiration Scale scores (Rosenbek, Robbins, Roecker, Coyle, & Wood, 1996), diet orders, Functional Oral Intake Scale scores...