Exploration and approach to artificial airway dysphagia

Fernández-Carmona, A.; Peñas-Maldonado, L.; Yuste-Osorio, E.; Díaz-Redondo, Alicia

doi:10.1016/j.medine.2012.09.001

Cited by 22 publications

(13 citation statements)

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“…The oral flora of intubated patients contains pathogenic bacteria [29]. Shifting oral secretions through the larynx into the lower respiratory tract can cause infections and inflammatory pulmonary complications [30]. The second way to develop aspiration pneumonia is by aspiration of gastric content [29].…”

Section: Causes Of Postintubation Dysphagiamentioning

confidence: 99%

“…Intubation may cause atrophy of the structures involved in swallowing act [50]. Orotracheal intubation tube retains glottis open for extended periods of time, inhibiting the natural movement of the laryngeal and pharyngeal muscles [30]. Movements of the intrinsic muscles of the larynx, which are necessary, e.g., in reflexive vocal cord closure, are also negatively affected by the presence of the orotracheal intubation tube [30].…”

Section: Neuromuscular Weaknessmentioning

confidence: 99%

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Postintubation Dysphagia During COVID-19 Outbreak-Contemporary Review

et al. 2020

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The COVID-19 is a global pandemic. Its rapid dissemination and serious course require a novel approach to healthcare practices. Severe disease progression is often associated with the development of the Acute Respiratory Distress Syndrome and may require some form of respiratory support, including endotracheal intubation, mechanical ventilation, and enteral nutrition through a nasogastric tube. These conditions increase the risk of dysphagia, aspiration, and aspiration pneumonia. The data on the incidence and risks of dysphagia associated with COVID-19 are not yet available. However, it is assumed that these patients are at high risk, because of respiratory symptoms and reduced lung function. These findings may exacerbate swallowing deficits. The aim of this review is to summarize available information on possible mechanisms of postintubation dysphagia in COVID-19 patients. Recommendations regarding the diagnosis and management of postintubation dysphagia in COVID-19 patients are described in this contemporary review.

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Section: Causes Of Postintubation Dysphagiamentioning

confidence: 99%

Section: Neuromuscular Weaknessmentioning

confidence: 99%

Postintubation Dysphagia During COVID-19 Outbreak-Contemporary Review

et al. 2020

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“…First, patients with lung diseases may have negative impacts on the breath-swallowing coordination pattern, leading to the occurrence of PSD [ 43 ]. Second, a history of tracheotomy may increase the incidence of dysphagia due to the invasive operation, possibly causing damage to the muscles and nerves that control the swallowing process [ 44 ] and causing changes in the biofluid mechanics in the trachea, consequently resulting in changes in the pharyngeal phase [ 45 ]. Third, dysarthria has proven to be an important predictor of dysphagia and helpful in the therapeutic process of swallowing problems [ 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Post-Stroke Cognitive Impairment and Severe Dysphagia: A Retrospective Cohort Study

Qiao

et al. 2022

Brain Sciences

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Objective: To investigate the relationship between post-stroke cognitive impairment (PSCI) and severe post-stroke dysphagia (PSD) and explore the risk factors related to PSCI combined with severe PSD. Methods: Data from patients were collated from the rehabilitation-specific disease database. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Videofluoroscopy Swallowing Study (VFSS), Penetration-aspiration Scale (PAS), and Functional Oral Intake Scale (FOIS) were used to evaluate cognitive and swallowing functions. Differences between groups were determined by the Pearson chi-square test (χ2) or Fisher exact test. PAS and FOIS data were analyzed with the use of the Wilcoxon rank-sum or Kruskal–Wallis test in the prespecified subgroup analysis. Risk factors were investigated by multivariate logistic regression. Results: A total of 1555 patients were identified with PSCI. The results indicated that patients with PSCI had a higher incidence rate of severe PSD as compared to patients without PSCI (p < 0.001). Patients with severe PSCI were more likely to clinically manifest oral phase dysfunction (p = 0.024), while mild PSCI patients mainly manifested pharyngeal phase dysfunction (p < 0.001). There was a significant difference in FOIS score changes between subgroups during the hospitalization period (severe PSCI vs. moderate PSCI and severe PSCI vs. mild PSCI) (all p < 0.001). In addition, multivariate logistic regression revealed pneumonia (p < 0.001), tracheotomy (p < 0.001), and dysarthria (p = 0.006) were related to PSCI, combined with severe PSD. Conclusion: PSCI may be related to severe PSD. Patients with severe PSCI were more likely to manifest oral phase dysfunction, while mild PSCI manifested pharyngeal phase dysfunction. Pneumonia, tracheotomy, and dysarthria were risk factors related to PSCI combined with severe PSD.

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“…11 A number of possible specific swallowing dysfunctional conditions arise in PMV patients; to mention a few, sarcopenic dysphagia, presbyphagia, neuromuscular dysfunction related dysphagia and even with some structural swallowing disorders. 12 Overall evaluation measures and treatment are based on experiments with different methodologies 13,14 but not on controlled studies which consider the unique pathophysiology of chronic critically ill patients. 15 It is worth mentioning the potential role of fiberoptic endoscopic evaluation of swallowing (FEES) as an objective tool to precisely classify and guide therapeutic interventions after prolonged intubation and in tracheostomy patients.…”

Section: Swallowing Dysfunctionmentioning

confidence: 99%