Catriona M. Steele, PhD, CCC-SLP, S-LP(C), Reg. CASLPO, ASHA Fellow
University Health Network, Toronto, ON

Renata Mancopes, PhD
University Health Network, Toronto, ON

The upper aerodigestive tract exists as a conduit both for food and liquid in swallowing and for air in breathing and speech production. Safe swallowing requires reconfiguration of the oropharynx from a respiratory into an ingestive pathway via closure of the laryngeal vestibule. Aspiration (entry of food, liquid or salivary secretions into the lower airway) is widely considered a risk for respiratory sequelae in people with oropharyngeal dysphagia (swallowing impairment). Individuals with current pneumonia or chronic obstructive pulmonary disease may also be at increased risk for aspiration. However, the links between aspiration and pneumonia or chronic respiratory disease exacerbation remain unclear. Consequently, the benefits of swallowing assessment for patients with chronic respiratory disease and of interventions to manage aspiration remain controversial. Professors Steele and Mancopes will unpack these issues, sharing current evidence regarding the relationships between aspiration and pneumonia and pathophysiological changes in swallowing in individuals with chronic respiratory disease.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe three factors thought to explain the pathogenesis of aspiration pneumonia in people with dysphagia;
  • List three changes in swallowing physiology that have been observed in people with COPD, which represent a risk for aspiration; and
  • Describe how modified liquid consistencies work to improve airway protection in people who aspirate thin liquids.

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar