Use of arterial oxygen saturation, heart rate, and blood pressure as indirect objective physiologic markers to predict aspiration

If an indirect bedside variable can reliably predict whether an objective i nstrumental dysphagia evaluation is needed, time and money can be saved wit hout compromising patient care. To date, the search for a reliable indirect subjective marker of aspiration has not been successful. However, research on indirect objective markers of aspiration is alluring. The purpose of th e present study was to investigate changes, if any, in the physiologic para meters of arterial oxygen saturation (SpO(2)), heart rate, and blood pressu re during simultaneous objective confirmation of aspiration status with Fib eroptic Endoscopic Evaluation of Swallowing (FEES(R)). Sixty adult subjects were divided into 4 groups of 15. Group 1 did not require supplemental oxy gen and did not aspirate. Group 2 did not require supplemental oxygen and e xhibited aspiration. Group 3 required supplemental oxygen and did not aspir ate. Group 4 required supplemental oxygen and exhibited aspiration. Simulta neous SpO(2), heart rate, and blood pressure measurements were collected at 1-min intervals, i.e., pre-FEES baseline for 5 min; during FEES; and post- FEES for 5 min. Results indicated no significant differences in SpO(2) leve ls based on aspiration status or oxygen requirements for any of the 4 group s. A consistent pattern of higher heart rate values during FEES and continu ing for 5 min post-FEES was observed for all 4 groups. A consistent pattern of higher blood pressure values during FEES and then lower blood pressure Values post-FEES was observed for all 4 groups. It was concluded that the u se of changes in SpO(2), heart rate, or blood pressure values as indirect o bjective markers of aspiration was not supported.