oral endotracheal intubation dysphagia

OBJECTIVE: This review evaluates the efficacy and safety of dysphagia interventions for patients with prolonged endotracheal intubation (⩾48 h) in critical care units. DATA SOURCES: We systematically searched PubMed, Cochrane Library, Medline, Embase, OVID, CINAHL, Wanfang (China), CNKI (China), and ProQuest Dissertations for studies published up to December 31, 2023. STUDY SELECTION: Inclusion criteria encompassed randomized controlled trials (RCTs), quasi-randomized trials, and cohort studies comparing dysphagia rehabilitation - such as swallowing stimulation, swallowing and respiratory muscle exercise, and neuromuscular electrical stimulation - with standard care or no treatment...

Tapia's syndrome is a rare complication of airway manipulation, involving the simultaneous paralysis of the hypoglossal nerve and the recurrent laryngeal nerve. The etiological mechanism is commonly attributed to compression or stretching during airway manipulation. An efficient recognition of this condition is pivotal for a comprehensive multidisciplinary approach and optimized recovery time. The presence of persistent dysphagia and dysphonia, coupled with observable deviation or restriction of tongue movement, not only after oral endotracheal intubation for surgical interventions with general anesthesia but also after a prolonged orotracheal intubation period in the intensive care, should heighten the suspicion of this syndrome...

INTRODUCTION: Endotracheal intubation and mechanical ventilation are the most frequently used life-sustaining interventions in critical care. Prolonged intubation can lead to post-extubation dysphagia, affecting the individual's nutritional level and communication ability. Thereupon, this study aims to assess the effectiveness of swallowing and oral care interventions in resuming oral intake and increasing salivary flow in post-extubation patients. METHODS: A randomized controlled trial was conducted in critical care units of a tertiary care setting, where 92 post-extubation patients who had undergone intubation for≥48 hours were enrolled...

INTRODUCTION: Postoperative laryngopharyngeal discomfort after extubation can lead to severe throat pain, dysphagia, or postoperative tongue oedema. Possible mechanisms include increased oral pressure, obstruction of venous and lymphatic return in the neck, and increased capillary hydrostatic pressure, which leads to oedema of the tongue and upper airway. However, real-time monitoring indicators of anaesthesia are lacking. Therefore, we designed this study to accurately measure the contact force of the tracheal tube on the tongue in different surgical positions during general anaesthesia...

BACKGROUND: The resumption of oral feeding and free from pneumonia are important therapeutic goals for critically ill patients who have been successfully extubated after prolonged (≥ 48 h) endotracheal intubation. We aimed to examine whether a swallowing and oral-care (SOC) program provided to critically ill patients extubated from prolonged mechanical ventilation improves their oral-feeding resumption and reduces 30-day pneumonia incidence. METHODS: In this randomized, open-label, controlled trial, participants were consecutively enrolled and randomized to receive the SOC program or usual care...

BACKGROUND: There is no objective quantitative parameter for dysphagia, and the relationship between changes in maximum tongue pressure values and dysphagia is unknown. This study aimed to determine whether there is a difference in the change in maximal tongue pressure after extubating patients who were ventilated after cardiovascular surgery, with or without dysphagia. MATERIALS AND METHODS: Adult patients who underwent mechanical ventilation via endotracheal intubation following cardiovascular surgery were included...

BACKGROUND: Postextubation dysphagia is a known consequence of endotracheal intubation. Several risk factors for postextubation dysphagia have been identified that could be used to help determine which patients should undergo swallowing assessment by an appropriate professional. LOCAL PROBLEM: At the authors' institution, critical care nurses, health care providers, and speech-language pathology professionals lacked a clear process for referring patients for swallowing assessment after extubation, resulting in inefficiency and confusion...

BACKGROUND: Pipeline dredging agents are new household deep cleaning products used to dredge blockages in kitchen and bathroom pipeline caused by grease, hair, vegetable residue, paper cotton fibre, and other organic substances. Pipeline dredging agents are corrosive chemicals that can cause poisoning through corrosive damage to the digestive tract; however, this has not been reported clinically. Therefore, this report emphasises that oral pipeline dredging agent poisoning can cause corrosive damage to the digestive tract and may have serious health consequences...

Management with ventilation is used for severe cases of coronavirus disease 2019 (COVID-19). After extubation, recurrent laryngeal nerve paralysis due to various factors may occur. Almost all cases of paralysis develop unilaterally; however, bilateral recurrent laryngeal nerve paralysis occurs rarely. Such cases may be fatal due to upper air obstruction, and patients are forced to adhere to restrictions after a tracheotomy. The present case illustrates bilateral recurrent laryngeal nerve paralysis that occurred 48 hours after withdrawal from the ventilator...

BACKGROUND: When a patient emerges from cardiac surgery, they may experience intense thirst and discomfort or even impaired swallowing after endotracheal extubation. This may lead to feelings of suffocation, desperation, fear, and anxiety. Although thirst relief and dysphagia prevention share similar mechanisms, there is limited evidence for a combined intervention to alleviate thirst and prevent dysphagia. Furthermore, no studies to date have targeted postoperative cardiac patients. OBJECTIVE: To evaluate the safety, feasibility, and effects of a spray-based oropharyngeal moisturising programme for cardiac surgery patients following endotracheal extubation...

BACKGROUND: To meet the surging demands for intubation and invasive ventilation as more COVID-19 patients begin their recovery, clinicians are challenged to find an ultra-brief and minimally invasive screen for postextubation dysphagia predicting feeding-tube dependence persisting for 72 h after extubation. METHODS: This study examined the predictive validity of a two-item swallowing screen on feeding-tube dependence over 72 h in patients following endotracheal extubation...

The aims and objectives of this study were to study clinical profile and factors affecting mortality in tetanus. This was a retrospective study of 25 tetanus patients (aged 6 months-12 years) admitted to pediatric intensive care unit of a tertiary center (over 3 years). In this study, 25 tetanus cases (mean age 6.6 years) were analyzed; 16 were males and 9 were females. Incubation period ranged from 2 to 30 days (mean 8.2 days), period of onset from 11 to 120 hours (mean 42.8 hours), and duration of spasms from 4 to 26 days (mean 14 days)...

OBJECTIVES: The study objectives were to determine the prevalence of swallowing impairment in adults after cardiac surgery and examine associated risk factors and health-related outcomes. METHODS: A prospective single-center study was conducted in postoperative adult cardiac surgery patients with no history of dysphagia. A standardized fiberoptic endoscopic evaluation of swallowing was performed within 72 hours of extubation. Blinded raters completed validated outcomes of swallowing safety and efficiency...

Dysphagia is the difficulty in swallowing because of the presence of certain diseases; it particularly compromises the oral and/or pharyngeal stages. In severe acute respiratory syndrome coronavirus 2 infection, neuromuscular complications, prolonged bed rest, and endotracheal intubation target different levels of the swallowing network. Thus, critically ill patients are prone to dysphagia and aspiration pneumonia. In this review, we first discuss the possible cause and pathophysiology underlying dysphagia associated with coronavirus disease 2019, including cerebrovascular events, such as stroke, encephalomyelitis, encephalopathy, peripheral neuropathy, and myositis, that may lead to the dysphagia reported as a complication associated with the coronavirus disease 2019...

Oral health is a crucial but often neglected aspect of rehabilitation medicine. Approximately 71% of hospitalized rehabilitation patients and 91% of hospitalized acute care patients have impaired oral health. Poor oral condition in hospitalized patients can be attributed to factors such as age, physical dependency, cognitive decline, malnutrition, low skeletal muscle mass and strength, and multimorbidity. Another major factor is a lack of knowledge and interest in oral problems among health care workers. Recently, new concepts have been proposed, such as oral frailty, oral sarcopenia, and hospital-associated oral problems...

BACKGROUND: Tapia syndrome is a rare complication of surgical positioning with resulting unilateral cranial nerve X and XII deficits that may provide diagnostic challenges in the perioperative period. Timely diagnosis will facilitate obtaining the necessary supportive care while preventing unnecessary workup and procedures. CASE DESCRIPTION: The following case report illustrates a patient that developed Tapia syndrome immediately after a posterior cervical laminoplasty with eventual resolution of symptoms...

BACKGROUND: For patients who survive a critical illness and have their oral endotracheal tube removed, dysphagia is highly prevalent, and without intervention, it may persist far beyond hospital discharge. This pre- and post-intervention study with historical controls tested the effects of a swallowing and oral care (SOC) intervention on patients' time to resume oral intake and salivary flow following endotracheal extubation. METHODS: The sample comprised intensive care unit patients (≥ 50 years) successfully extubated after ≥ 48 h endotracheal intubation...

OBJECTIVES: To systematically review the symptoms and types of laryngeal injuries resulting from endotracheal intubation in mechanically ventilated patients in the ICU. DATA SOURCES: PubMed, Embase, CINAHL, and Cochrane Library from database inception to September 2017. STUDY SELECTION: Studies of adult patients who were endotracheally intubated with mechanical ventilation in the ICU and completed postextubation laryngeal examinations with either direct or indirect visualization...

OBJECTIVES: Postextubation dysphagia is common and associated with worse outcomes in the PICU. Although there has been an increased participation of speech-language pathologists in its treatment, there is limited evidence to support speech-language pathologists as core PICU team member. We aimed to assess the impact of speech-language pathologists interventions on the treatment of postextubation dysphagia. DESIGN: A quasi-experimental prospective study. In the historical group (controls), patients received a standard care management for dysphagia whereas the intervention group was routinely treated by speech-language pathologists...

Objective: To prospectively assess the association between impoverished sensorimotor integration of the tongue and lips and post-extubation dysphagia (PED). Methods: This cross-sectional study included non-neurologic critically ill adult patients who required endotracheal intubation and underwent videofluoroscopic swallowing study (VFSS) between October and December 2016. Participants underwent evaluation for tongue and lip performance, and oral somatosensory function...