Post-extubation dysphagia in trauma patients: it's hard to swallow

Kwok, Amy M.; Davis, James W.; Cagle, Kathleen M.; Sue, Lawrence P.; Kaups, Krista L.

doi:10.1016/j.amjsurg.2013.08.010

Cited by 89 publications

(86 citation statements)

References 8 publications

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“…There are multiple considerations to account for this result, such as poor glottic closure due to vocal process granulomas, ulceration, or edema. 35 The frequency of aspiration was different between groups (18.2% within 24 hours vs 33.3% after 24 hours). It seems likely that emergent intubations are more likely to cause laryngeal damage and result in dysphagia.…”

Section: Discussionmentioning

confidence: 88%

Endoscopic Assessment of Swallowing After Prolonged Intubation in the ICU Setting

Scheel

Pisegna

McNally

et al. 2015

Ann Otol Rhinol Laryngol

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This study found a high frequency of dysphagia after prolonged intubation in patients with no preexisting dysphagia. Important variables leading to dysphagia are often overlooked, such as swallowing delay and laryngeal pathology. The timing of swallowing assessments did not reveal any difference in dysphagia frequency, suggesting that it might not be necessary to wait to perform dysphagia screens or evaluations.

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Section: Discussionmentioning

confidence: 88%

Endoscopic Assessment of Swallowing After Prolonged Intubation in the ICU Setting

Scheel

Pisegna

McNally

et al. 2015

Ann Otol Rhinol Laryngol

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“…[3,5] Briefly, older age has been associated with a higher incidence of PSD in several studies, [1,5–7] but other work has shown age to be unrelated. [2,8–15] In a retrospective study, the odds of 70 critically ill patients having severe PSD increased by 7.5% for each additional year of age, [15] but age was unrelated in another study.…”

Section: Introductionmentioning

confidence: 99%

Swallowing dysfunction following endotracheal intubation

Tsai

Wang

et al. 2016

Medicine

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To evaluate postextubation swallowing dysfunction (PSD) 21 days after endotracheal extubation and to examine whether PSD is time-limited and whether age matters.For this prospective cohort study, we evaluated 151 adult critical care patients (≥20 years) who were intubated for at least 48 hours and had no pre-existing neuromuscular disease or swallowing dysfunction. Participants were assessed for time (days) to pass bedside swallow evaluations (swallow 50 mL of water without difficulty) and to resume total oral intake. Outcomes were compared between younger (20–64 years) and older participants (≥65 years).PSD, defined as inability to swallow 50 mL of water within 48 hours after extubation, affected 92 participants (61.7% of our sample). At 21 days postextubation, 17 participants (15.5%) still failed to resume total oral intake and were feeding-tube dependent. We found that older participants had higher PSD rates at 7, 14, and 21 days postextubation, and took significantly longer to pass the bedside swallow evaluations (5.0 vs 3.0 days; P = 0.006) and to resume total oral intake (5.0 vs 3.0 days; P = 0.003) than their younger counterparts. Older participants also had significantly higher rates of subsequent feeding-tube dependence than younger patients (24.1 vs 5.8%; P = 0.008).Excluding patients with pre-existing neuromuscular dysfunction, PSD is common and prolonged. Age matters in the time needed to recover. Swallowing and oral intake should be monitored and interventions made, if needed, in the first 7 to 14 days postextubation, particularly for older patients.

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“…The studies investigated showed that prolonged intubation may be an independent predictor for dysphagia (18) and that artificial airways increase the risk of lesions in the upper airways and the larynx, which, in turn, affect the mechanics, aerodynamics, and reflex protection of the first (36) . Kwok et al (37) demonstrated that orotracheal intubation (OI) time is strongly associated with post-extubation dysphagia. Each day, after the first 24 hours on mechanical ventilation, increased the odds of developing dysphagia by 25%.…”

Section: Characterization Of Studiesmentioning

confidence: 99%

Fatores relacionados à disfagia orofaríngea no pós-operatório de cirurgia cardíaca: revisão sistemática

Werle

Steidl

Mancopes

2016

CoDAS

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RESUMO Objetivo Identificar os principais fatores relacionados à disfagia orofaríngea no pós-operatório de cirurgia cardíaca, por meio de uma revisão sistemática de literatura. Método Foi realizada pesquisa bibliográfica nas bases PubMed e ScienceDirect, utilizando os termos cardiac surgery, deglutition disorders e dysphagia. Critérios de seleção Foram selecionados artigos sem limitação de ano escritos em português, inglês ou espanhol e que referissem disfagia orofaríngea no pós-operatório de cirurgia cardíaca. Apenas os estudos disponíveis na íntegra foram incluídos. Análise dos dados Cada artigo passou pela análise de títulos e resumos, sendo posteriormente submetido à avaliação na íntegra por dois juízes cegados. Os seguintes dados foram extraídos: autores/ano, desenho do estudo, amostra, variáveis avaliadas e principais resultados. Resultados Os principais fatores relacionados à disfagia orofaríngea no pós-operatório de cirurgia cardíaca foram: idade avançada, presença de comorbidades e outras doenças associadas, tempo de intubação e condições cirúrgicas. Conclusão Os estudos foram bastante heterogêneos, demonstrando que sujeitos submetidos a procedimentos cirúrgicos cardíacos, em especial idosos, apresentam diversos fatores relacionados à disfagia orofaríngea no pós-operatório, como o uso de circulação extracorpórea e ecocardiografia transesofágica, comorbidades associadas, desenvolvimento de sepse pós-operatória e condições cardíacas prévias.

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Post-extubation dysphagia in trauma patients: it's hard to swallow

Cited by 89 publications

References 8 publications

Endoscopic Assessment of Swallowing After Prolonged Intubation in the ICU Setting

Endoscopic Assessment of Swallowing After Prolonged Intubation in the ICU Setting

Swallowing dysfunction following endotracheal intubation

Fatores relacionados à disfagia orofaríngea no pós-operatório de cirurgia cardíaca: revisão sistemática

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