Cough reflex testing in clinical dysphagia practice

Abstract

The addition of cough reflex testing (CRT) to a comprehensive clinical swallowing evaluation has the potential to substantially contribute to the management of patients with dysphagia, by providing insights into the integrity of the cough response to airway invasion and risk of silent aspiration. This 'Spotlight on: Cough Reflex Testing in Clinical Dysphagia Practice' outlines the theoretical and practical considerations of using CRT as a screening tool to identify patients' risk of silent aspiration. The following clinical questions are addressed: (1) What is coughing? (2) What is CRT? (3) What CRT method should I use? (4) How is the citric acid CRT conducted? (5) Can CRT be repeated to monitor changes in cough sensitivity? (6) What are the benefits of CRT in clinical dysphagia practice? This information is intended to support clinicians in implementing and interpreting CRT as a screening tool to identify patients' risk of silent aspiration in clinical dysphagia practice.