Swallowing dysfunction following endotracheal intubation Age matters

Min Hsuan Tsai, Shih Chi Ku, Tyng Guey Wang, Tzu Yu Hsiao, Jang Jaer Lee, Ding Cheng Chan, Guan-Hua Huang, Cheryl Chia Hui Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

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 48hours and had no pre-existing neuromuscular disease or swallowing dysfunction. Participants were assessed for time (days) to pass bedside swallow evaluations (swallow 50mL 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 50mL of water within 48hours 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.

Original languageEnglish
Article numbere3871
JournalMedicine (United States)
Volume95
Issue number24
DOIs
StatePublished - 21 Jun 2016

Keywords

  • Aging
  • Dysphagia
  • Intensive care unit
  • Oral intake level
  • Oral intubation
  • Swallowing functions

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