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Dawson C, Nankivell P, Pracy JP, Capewell R, Wood M, Weblin J, Parekh D, Patel J, Skoretz SA, Sharma N. Functional Laryngeal Assessment in Patients with Tracheostomy Following COVID-19 a Prospective Cohort Study. Dysphagia 2023; 38:657-666. [PMID: 35841455 PMCID: PMC9287536 DOI: 10.1007/s00455-022-10496-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 07/01/2022] [Indexed: 11/03/2022]
Abstract
To explore laryngeal function of tracheostomised patients with COVID-19 in the acute phase, to identify ways teams may facilitate and expedite tracheostomy weaning and rehabilitation of upper airway function. Consecutive tracheostomised patients underwent laryngeal examination during mechanical ventilation weaning. Primary outcomes included prevalence of upper aerodigestive oedema and airway protection during swallow, tracheostomy duration, ICU frailty scores, and oral intake type. Analyses included bivariate associations and exploratory multivariable regressions. 48 consecutive patients who underwent tracheostomy insertion as part of their respiratory wean following invasive ventilation in a single UK tertiary hospital were included. 21 (43.8%) had impaired airway protection on swallow (PAS ≥ 3) with 32 (66.7%) having marked airway oedema in at least one laryngeal area. Impaired airway protection was associated with longer total artificial airway duration (p = 0.008), longer tracheostomy tube duration (p = 0.007), multiple intubations (p = 0.006) and was associated with persistent ICU acquired weakness at ICU discharge (p = 0.03). Impaired airway protection was also an independent predictor for longer tracheostomy tube duration (p = 0.02, Beta 0.38, 95% CI 2.36 to 27.16). The majority of our study patients presented with complex laryngeal findings which were associated with impaired airway protection. We suggest a proactive standardized scoring and review protocol to manage this complex group of patients in order to maximize health outcomes and ICU resources. Early laryngeal assessment may facilitate weaning from invasive mechanical ventilation and liberation from tracheostomy, as well as practical and objective risk stratification for patients regarding decannulation and feeding.
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Srivastava P, Kransdorf E, Kittleson M, Chang D, Nikolova A, Patel J, Kobashigawa J. Mixed Rejection in Orthotopic Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Patel J, Kittleson M, Patel N, Singer-Englar T, Kim S, Thein S, Norland K, Hage A, Czer L, Emerson D, Kobashigawa J. High HDL Levels are Associated with Survival Benefit after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Premananthan C, Chen Q, Malas J, Emerson D, Megna D, Catarino P, Kobashigawa J, Kittleson M, Patel J, Chikwe J, Bowdish M, Esmailian F. Impact of the 2018 Adult Heart Allocation Policy Change on the Incidence of Primary Graft Dysfunction after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Patel J, Kittleson M, Moriguchi J, Singer-Englar T, Kim S, De Leon F, Runyan C, Czer L, Emerson D, Megna D, Esmailian F, Kobashigawa J. Does Right Ventricular Support with Mechanical Assist Devices Compromise Outcome for Heart Transplantation? J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Stachel M, Patel J, Kittleson M, Chang D, Patel N, Singer-Englar T, Ross V, De Leon F, Hamilton M, Czer L, Esmailian F, Kobashigawa J. Revisiting Hemodynamic Compromise Rejection in the Current Era of Heart Transplantation: Still Problematic. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Patel J, Kittleson M, Chang D, Kim S, Singer-Englar T, Dixon V, Azarbal B, Czer L, Hage A, Esmailian F, Kobashigawa J. Does Donor Age Impact Outcomes for MCS Patients Undergoing Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Shen A, Patel J, Kittleson M, Chang D, Esmailian G, Singer-Englar T, De Leon F, Hamilton M, Geft D, Czer L, Megna D, Kobashigawa J. Transthyretin Amyloid May Have a Protective Effect for Rejection after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Fardman A, Nachum E, Wieder A, Morgan A, Lavee J, Ashkenazi T, Patel J, Peled Y. Is Heart Transplantation from Mycobacterium Tuberculosis Positive Donor Safe? J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Fardman A, Nachum E, Morgan A, Lavee J, Fink T, Kuperstein R, Shapira Y, Patel J, Peled Y. 'Un-Break My Heart' - Successful Heart Transplantation From A Donor with Reverse Takotsubo Syndrome. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kittleson M, Patel J, Moriguchi J, Cole R, Singer-Englar T, Patel N, Runyan C, Welton M, Czer L, Catarino P, Kobashigawa J. Do Older LVAD Patients Have Compromised Outcome after Heart Transplantation: Should They Stay as Destination Therapy? J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kittleson M, Patel J, Nikolova A, Patel N, Singer-Englar T, Hu J, De Leon F, Hamilton M, Czer L, Esmailian F, Kobashigawa J. What Should the GFR Threshold Be for Redo Heart Transplant Patients to Qualify for Combined Heart-Kidney Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kittleson M, Patel J, Hage A, Geft D, Singer-Englar T, Kim S, Velleca A, Hamilton M, Czer L, Esmailian F, Kobashigawa J. Oversized Donors for Patients with Pulmonary Hypertension Awaiting Heart Transplant: Busting the Myth of Using Female Donors. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Giarraputo A, Coutance G, Fedrigo M, Aubert O, Dagobert J, Robin B, Barison I, Mezine F, Castellani C, Rouvier P, Bruneval P, Patel J, Duong-Van-Huyen J, Angelini A, Loupy A. Molecular Diagnostic Classification of Heart Allograft Rejection Based on the Targeted Banff Human Organ Transplant Gene Expression Panel. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kittleson M, Patel J, Azarbal B, Patel N, Singer-Englar T, Yeomans T, Esmailian G, Nikolova A, Hage A, Emerson D, Czer L, Kobashigawa J. In-Stent Re-Stenosis for Cardiac Allograft Vasculopathy in the Current Era for Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kittleson M, Patel J, Singer-Englar T, Kim S, Patel N, Wakefield Z, Welton M, Czer L, Esmailian F, Kobashigawa J. Are Redo Heart Transplant Patients Appropriately Listed as Status 4 on the Waitlist. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kittleson M, Patel J, Chang D, Patel N, Esmailian G, Singer-Englar T, Runyan C, Moriguchi J, Czer L, Esmailian F, Kobashigawa J. Is Chronic Kidney Disease Truly a Contraindication for Total Artificial Heart Candidacy and Subsequent Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Patel N, Kittleson M, Chang D, Patel J, Azarbal B, Singer-Englar T, Geft D, Czer L, Esmailian F, Kobashigawa J. Validation of the Cardiac Allograft Vasculopathy (CAV) Trajectory Score after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Chang D, Kittleson M, Patel J, Singer-Englar T, Kim S, Hage P, Norland K, Czer L, Esmailian F, Jordan S, Kobashigawa J. Outcome of the Kidney in Heart-Kidney Transplant - Does It Take an Immune Hit. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kittleson M, Patel J, Azarbal B, Kim S, Singer-Englar T, Trajano R, Velleca A, Geft D, Megna D, Czer L, Kobashigawa J. Cardiac Allograft Vasculopathy Trajectory Score Helpful to Avoid Annual Angiograms in Heart-Kidney Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kim D, Youn J, Kim J, Kim I, Choi J, Kransdorf E, Chang D, Kittleson M, Patel J, Cole R, Moriguchi J, Esmailian F, Kobashigawa J. Clinical Outcomes of Heart Transplantation in Desensitized Durable Mechanical Circulatory Support Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Kim I, Youn J, Chang D, Nishihara K, Kransdorf E, Kittleson M, Patel J, Cole R, Nikolova A, Esmailian F, Czer L, Kobashigawa J. The Validation of Cardiac Rehabilitation after Heart Transplantation from Anonymized Patient-Reported Outcomes. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Jyothula S, Hussain R, Patel M, Patel J, Pham C, Levine D. Donor Derived Cell Free DNA in Lung Transplant Recipients with COVID Based on Hospitalization. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Tardo D, Carlos L, Burrows F, Carroll R, Tong W, Patel P, Taverniti A, Wiltshire S, Conte S, Parvar S, Emmanuel S, Grealy R, Hayward C, Bart N, Kotlyar E, Jabbour A, Keogh A, Patel J, Jansz P, Macdonald P, Muthiah K. Combined Plasmapheresis and Complement Inhibition in a Highly Allosensitized Cardiac Transplant Recipient. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Dhillon M, Kobashigawa J, Patel N, Kittleson M, Zhang X, Patel J. Does Bortezomib Have an Effect on Pre-Transplant Desensitization Therapy or Benefit Post-Heart Transplant Outcomes for Highly Sensitized Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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