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Post extubation dysphagia

Min Jung Kim, Yun Hee Park, Young Sook Park, You Hong Song
OBJECTIVE: To identify the associations between the duration of endotracheal intubation and developing post-extubational supraglottic and infraglottic aspiration (PEA) and subsequent aspiration pneumonia. METHODS: This was a retrospective observational study from January 2009 to November 2014 of all adult patients who had non-neurologic critical illness, required endotracheal intubation and were referred for videofluoroscopic swallowing study. Demographic information, intensive care unit (ICU) admission diagnosis, severity of critical illness, duration of endotracheal intubation, length of stay in ICU, presence of PEA and severity of dysphagia were reviewed...
October 2015: Annals of Rehabilitation Medicine
Rebecca Scheel, Jessica M Pisegna, Edel McNally, Jacob Pieter Noordzij, Susan E Langmore
OBJECTIVES: The purpose of this study was to identify the frequency of swallowing dysfunction after extubation in a sample of patients with no preexisting dysphagia. METHODS: Mechanically ventilated patients in the ICU with no prior history of dysphagia received a flexible endoscopic evaluation of swallowing (FEES) exam within 72 hours after extubation. The FEES was then analyzed for variables related to swallowing patterns and laryngeal pathology. Univariate analyses were performed to identify relationships between variables...
January 2016: Annals of Otology, Rhinology, and Laryngology
Han Su, Tzu-Yu Hsiao, Shih-Chi Ku, Tyng-Guey Wang, Jang-Jaer Lee, Wen-Chii Tzeng, Guan-Hua Huang, Cheryl Chia-Hui Chen
The tongue plays important roles in mastication, swallowing, and speech, but its sensorimotor function might be affected by endotracheal intubation. The objective of this pilot study was to describe disturbances in the sensorimotor functions of the tongue over 14 days following oral endotracheal extubation. We examined 30 post-extubated patients who had prolonged (≥48 h) oral endotracheal intubation from six medical intensive care units. Another 36 patients were recruited and examined from dental and geriatric outpatient clinics served as a comparison group...
April 2015: Dysphagia
Stacey A Skoretz, Terrence M Yau, Joan Ivanov, John T Granton, Rosemary Martino
Following cardiovascular (CV) surgery, prolonged mechanical ventilation of >48 h increases dysphagia frequency over tenfold: 51 % compared to 3-4 % across all durations. Our primary objective was to identify dysphagia frequency following CV surgery with respect to intubation duration. Our secondary objective was to explore characteristics associated with dysphagia across the entire sample. Using a retrospective design, we stratified all consecutive patients who underwent CV surgery in 2009 at our institution into intubation duration groups defined a priori: I (≤ 12 h), II (>12 to ≤ 24 h), III (>24 to ≤ 48 h), and IV (>48 h)...
December 2014: Dysphagia
Gisele Chagas de Medeiros, Fernanda Chiarion Sassi, Laura Davison Mangilli, Bruno Zilberstein, Claudia Regina Furquim de Andrade
OBJECTIVES: To elucidate independent risk factors for dysphagia after prolonged orotracheal intubation. METHODS: The participants were 148 consecutive patients who underwent clinical bedside swallowing assessments from September 2009 to September 2011. All patients had received prolonged orotracheal intubations and were admitted to one of several intensive care units of a large Brazilian school hospital. The correlations between the conducted water swallow test results and dysphagia risk levels were analyzed for statistical significance...
January 2014: Clinics
Amirali Orandi, Amirhossein Orandi, Atabak Najafi, Fatemeh Hajimohammadi, Sara Soleimani, Somayeh Zahabi
BACKGROUND: Postoperative sore throat is one of the most common complications of general anesthesia and intubation with prevalence of 18%-65% in different studies. Several risk factors including female gender, postoperative nausea and vomiting and so on have been mentioned. OBJECTIVES: The aim of this study was to evaluate the incidence of postoperative sore throat in females and its association with menstrual cycles. PATIENTS AND METHODS: One hundred females between 18-45 years old with ASA class I or II without predicted difficult airway that were candidate for operation in supine position were enrolled in study...
September 2013: Anesthesiology and Pain Medicine
Jude Rodrigues, Renny Furtado, Anant Ramani, Nivedita Mitta, Shantata Kudchadkar, Sanyam Falari
INTRODUCTION: In endemic goitre areas, 20% of the population over 70 will have retrosternal goitre.(12) Obstructive sleep apnoea (OSA) occurs when there are repeated episodes of complete or partial blockage of the upper airway during sleep. PRESENTATION OF CASE: A 55-year-old man was being treated for obstructive sleep apnoea, came with stridor worsening over the 2 and was advised CPAP ventilation. In our institution, he was diagnosed to have goitre with retrosternal extension with no hypo/hyperthyroidism...
2013: International Journal of Surgery Case Reports
Amy M Kwok, James W Davis, Kathleen M Cagle, Lawrence P Sue, Krista L Kaups
BACKGROUND: There is a significant incidence of unrecognized postextubation dysphagia in trauma patients. The purpose of this study was to evaluate the incidence, ascertain the risk factors, and identify patients with postextubation dysphagia who will require clinical swallow evaluation. METHODS: A prospective observational study was performed on 270 trauma patients. Bedside clinical swallow evaluation was done within 24 hours of extubation. Logistic regression analysis was used to adjust for confounding variables...
December 2013: American Journal of Surgery
David G Smithard
Post-extubation dysphagia is a common and serious problem. The presence of neuromuscular disease at the time of intubation is likely to increase this. Until recently, the prevalence and the association with length of intubation had not been clarified. Results published in this journal suggest that 93% of extubated patients with neuromuscular disease had post-extubation dysphagia, which in 33% of cases was considered severe. The number of days ventilated was the single predictor of severe dysphagia and a consequent prolonged hospital stay...
2013: Critical Care: the Official Journal of the Critical Care Forum
S T Smailes, M Ives, P Richardson, R V Martin, P Dziewulski
The aim of this study is to evaluate the incidence of complications and dysphagia in relation to the timing of tracheostomy and tracheostomy technique in 49 consecutive adult burn patients. We analysed prospectively collected data. Bronchoscopy was used to diagnose tracheal stenosis and a modified Evans blue dye test was used to diagnose dysphagia. Eighteen patients received a percutaneous dilatational tracheostomy (PDT) and thirty-one patients received an open surgical tracheostomy (OST). Eight patients developed significant complications (16%) following tracheostomy, there is no difference in the incidence of complications; post op infection, stoma infection or tracheal stenosis between PDT and OST groups...
May 2014: Burns: Journal of the International Society for Burn Injuries
Madison Macht, Christopher J King, Tim Wimbish, Brendan J Clark, Alexander B Benson, Ellen L Burnham, André Williams, Marc Moss
INTRODUCTION: Critically ill patients can develop acute respiratory failure requiring endotracheal intubation. Swallowing dysfunction after liberation from mechanical ventilation, also known as post-extubation dysphagia, is common and deleterious among patients without neurologic disease. However, the risk factors associated with the development of post-extubation dysphagia and its effect on hospital lengthofstay in critically ill patients with neurologic disorders remains relatively unexplored...
2013: Critical Care: the Official Journal of the Critical Care Forum
Madison Macht, Tim Wimbish, Brendan J Clark, Alexander B Benson, Ellen L Burnham, André Williams, Marc Moss
PURPOSE: This study sought to determine the utilization of speech-language pathologist (SLPs) for the diagnosis and treatment of post-extubation dysphagia in survivors of mechanical ventilation. METHODS: We designed, validated, and mailed a survey to 1,966 inpatient SLPs who routinely evaluate patients for post-extubation dysphagia. RESULTS: Most SLP diagnostic evaluations (60%; 95% CI, 59%-62%) were performed using clinical techniques with uncertain accuracy...
December 2012: Journal of Critical Care
Cristiano Radice, Fabio Stella, Lorena Salvini
OBJECT: The aim of this study was to assess whether free assumption of water in heart surgery patients, as early as one hour after extubation, produces measurable differences in thirst, nausea and vomiting. METHODS: Randomized controlled trial (pilot phase), by sex and age. Eventual cases of dysphagia are identified by both a functional examination and a water test. The sense of thirst and sickness are registered 1 hour post-extubation and subsequently at the 3rd, 6th and 12th hour using an NRS-scale 0-10...
April 2011: Professioni Infermieristiche
José Reinaldo Cerqueira Braz, Alexandre Volney, Laís Helena Camacho Navarro, Leandro Gobbo Braz, Giane Nakamura
STUDY OBJECTIVES: To study endotracheal tube (ETT) cuff pressures during nitrous oxide (N2O) anesthesia when the cuffs are inflated with air to achieve sealing pressure, and to evaluate the frequency of postoperative laryngotracheal complaints. DESIGN: Prospective, randomized, blind study. SETTING: Metropolitan teaching hospital. PATIENTS: 50 ASA physical status I and II patients scheduled for elective abdominal surgery...
August 2004: Journal of Clinical Anesthesia
C Sebening, H Jakob, U Tochtermann, R Lange, C F Vahl, P Bodegom, G Szabo, F Fleischer, K Schmidt, E Zilow, W Springer, H E Ulmer, S Hagl
Between January 1988 and December 1997 a total of 22 patients (age: 8 days-46 years) were operated for vascular airway compression syndromes with respiratory insufficiency. Vascular anomalies in tracheal compression were double aortic arch in 7 patients, (2 previously operated elsewhere), right aortic arch + left ligamentum arteriosum in 1, and pulmonary artery sling in 3. Three of these patients had secondary long-segment tracheomalacia. Compression of trachea and a main bronchus existed in 2 patients with right aortic arch + left ligamentum...
June 2000: Thoracic and Cardiovascular Surgeon
Y Motoi, K Satoh, H Matsumine, M Wakiya, H Mori, T Shirai, T Kondo, Y Mizuno
We report a 49-year-old man with progressive bulbar palsy and respiratory failure. He was well until his 48 years of the age (December 1994) when he noted a difficulty in speaking in loud voice. In February, 1995, he noted regurgitation of foods to his nose and difficulty in his speech. He was admitted to our service in May 29, 1995. On admission, he was alert and oriented to all spheres and he was not demented. His higher cerebral functions were normal. In cranial nerves, he showed dysarthria and dysphagia; muscle atrophies were seen in the tongue, the bilateral sternocleidomastoid, supraspinatus, and infraspinatus muscles...
January 1998: Nō to Shinkei, Brain and Nerve
I Kujundzić, V Cvetnić, M Zmire, B Hofman, M Popović, Z Passini, B Valdec, A Munitić
The authors examined and followed 104 patients who had undergone surgery under endotracheal anesthesia in order to recognize the lesions of the oropharynx and the larynx resulting from intubation and other manipulations within the oral cavity and the pharynx. Laryngoscopic examination disclosed: a hematoma of true vocal cords in 5 patients, hematoma of the aditus ad laryngem and soft palate in 1 patient, edema in 4 patients, and in 8 patients hematoma of the oropharyngeal mucosa. The patients reported the following post-extubation discomforts: sore throat, hoarseness, dysphagia, a feeling of burning, clenching or foreign body in the throat, rough throat, irritation to hacking cough, and pains in the cervical musculature...
January 1989: Lijec̆nic̆ki Vjesnik
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