Chest
Clinical Investigations in Critical CareSwallowing Dysfunction in Patients Receiving Prolonged Mechanical Ventilation
Section snippets
METHODS
All patients were admitted to a tertiary care, noninvasive respiratory care unit that is one of four national demonstration sites for the Health Care Financing Administration Chronic Ventilator Demonstration Project. Patients admitted to this unit receive aggressive whole body and respiratory reconditioning. The admission criteria and care plan are outlined in prior publications.3
Thirty-five consecutive ventilator-dependent patients underwent a bedside swallowing evaluation performed by an
RESULTS
The average age of the 35 patients was 61 ± 15 years; 21 were men. The total duration of intubation at the time of the initial swallowing evaluation was 29 ±34 days via a cuffed tracheostomy tube and 15 ±9 days via an endotracheal tube. Most patients required prolonged mechanical ventilation due to either an exacerbation of COPD (n=8) or ARDS (n=10). Other causes of respiratory failure included the following: postpolio syndrome/kyphoscoliosis, n=3; empyema, n=2; Guillain-Barré syndrome, n=2;
DISCUSSION
Our data show that patients with and without neuromuscular disorders requiring prolonged intubation (translaryngeal followed by tracheostomy) and positive pressure ventilation have a high incidence of swallowing abnormalities. Moreover, the types of swallowing abnormalities are complex and more than one type of abnormality is commonly present. Finally, MBS/VF and direct laryngoscopy can provide useful information about swallowing dysfunction that may help to prevent subsequent respiratory
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Utility of speaking valves in the rehabilitation of tracheostomized patient's communication and swallowing
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2022, Journal of Critical CareCitation Excerpt :Among these risk factors, the duration of mechanical ventilation has been associated with the occurrence of swallowing disorders. Endoscopic studies have found that swallowing dysfunction leading to aspiration in critically ill patients intubated for longer than 48 h are frequent, up to 80% [11-16]. These studies also demonstrated that expected clinical signs of aspiration such as cough, wheeze, stridor, tachypnea, cyanosis with feeds, oxygen desaturations, and noisy or wet breathing were not present in extubated patients with SD.
Swallowing Function in COVID-19 Patients After Invasive Mechanical Ventilation
2022, Archives of Rehabilitation Research and Clinical TranslationPrevalence and evaluation of oropharyngeal dysphagia in patients with severe acute respiratory syndrome coronavirus 2 infection in the intensive care unit
2022, Journal of Laryngology and Otology
Supported in part by a grant from the Health Care Financing Administration (HCFA) 29-P-99401/3/01.
revision accepted June 23.