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ICU dysphagia

Kay Choong See, Si Yu Peng, Jason Phua, Chew Lai Sum, Johncy Concepcion
BACKGROUND: Swallowing difficulties are common, and dysphagia occurs frequently in intensive care unit (ICU) patients after extubation. Yet, no guidelines on postextubation swallowing assessment exist. We aimed to investigate the safety and effectiveness of nurse-performed screening (NPS) for postextubation dysphagia in the medical ICU. METHODS: We conducted a retrospective cohort study of mechanically ventilated patients who were extubated in a 20-bed medical ICU...
October 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
Frans van Workum, Jolijn van der Maas, Frits J H van den Wildenberg, Fatih Polat, Ewout A Kouwenhoven, Marc J van Det, Grard A P Nieuwenhuijzen, Misha D Luyer, Camiel Rosman
BACKGROUND: Both cervical esophagogastric anastomosis (CEA) and intrathoracic esophagogastric anastomosis (IEA) are used to restore gastrointestinal integrity following minimally invasive esophagectomy (MIE). No prospective randomized data on functional outcome, postoperative morbidity, and mortality between these techniques are currently available. METHODS: A comparison was conducted including all consecutive patients with esophageal carcinoma of the distal esophagus or gastroesophageal junction undergoing MIE with CEA or MIE with IEA from October 2009 to July 2014 in 3 high-volume esophageal cancer centers...
September 24, 2016: Annals of Thoracic Surgery
Hani Osama Nasef, Hossam Thabet, Cesare Piazza, Francesca Del Bon, Mohamed Eid, Manal El Banna, Piero Nicolai
56 patients affected by T2 glottic carcinoma were treated in two institutes using transoral laser microsurgery (TLM) in 40 cases and vertical hemilaryngectomy in 16 cases between September 2012 and September 2015. In the TLM group, different subtypes of type V cordectomy were used according to the extent of tumor. In the vertical hemilaryngectomy group, classical operation was used in most of the cases and the resection was extended in few cases. Analysis of post-operative swallowing function was done using videofluoroscopy (VFS), functional endoscopic evaluation of swallowing, and subjectively using MD Anderson dysphagia inventory...
August 2016: European Archives of Oto-rhino-laryngology
Georgia A Malandraki, Vasiliki Markaki, Voula C Georgopoulos, Loukia Psychogios, Serafim Nanas
PURPOSE: This study provided preliminary data on the occurrence and impact of postextubation dysphagia in the largest Greek step-down intensive care unit (ICU) over 2 years. METHOD: A retrospective observational cohort study of patients referred for swallowing assessment postextubation was conducted from November, 2011, to August, 2013. RESULTS: Of the 357 patients admitted to the unit during this period, 87, aged 55.8 ± 18.1 years (61 male, 26 female), were referred and evaluated...
May 1, 2016: American Journal of Speech-language Pathology
Rahim Mahmodlou, Kamran Shateri, Faramarz Homayooni, Sanaz Hatami
BACKGROUND: Esophagectomy remains the most reliable technique for managing esophageal cancer, but anastomotic complications including postoperative leak, ischemia and stricture negatively affect outcomes of this specific surgery. The aim of this study was to evaluate the effects of a novel method of esophagogastric anastomosis for reducing postoperative dysphagia and stricture formation. METHODS: Eighty patients who were scheduled for esophagectomy due to esophageal cancer were randomly assigned into two groups: intervention and control (40 each)...
February 17, 2016: Gastroenterology Report
Lee Pryor, Elizabeth Ward, Petrea Cornwell, Stephanie O'Connor, Marianne Chapman
BACKGROUND: Dysphagia is often a comorbidity in patients who require a tracheostomy, yet little is known about patterns of oral intake commencement in tracheostomized patients, or how patterns may vary depending on the clinical population and/or reason for tracheostomy insertion. AIMS: To document patterns of clinical management around the commencement of oral intake throughout hospital admission and along the decannulation pathway in patients with a new tracheostomy, and to examine the nature of variability across multiple clinical populations...
September 2016: International Journal of Language & Communication Disorders
Jiaqing Xiong, Gita Krishnaswamy, Sharon Raynor, Kwok Seng Loh, Andrea Lay Hoon Kwa, Chwee Ming Lim
BACKGROUND: Pulmonary complications secondary to dysphagia may be encountered in patients with nasopharyngeal carcinoma (NPC) after definitive intensity-modulated radiotherapy. The purpose of this study was to identify patients with NPC at risk of developing swallowing-related chest infections (SRCIs). METHODS: Retrospective chart review was performed on 217 patients with stage I to IVB NPC treated definitively with radiotherapy or chemoradiotherapy. RESULTS: Twenty-six patients (12...
April 2016: Head & Neck
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
C Herren, M Pishnamaz, P Lichte, F Hildebrand, R M Sellei, H-C Pape, P Kobbe
INTRODUCTION: In geriatric patients the management of odontoid type II fractures is complicated by osteoporosis and atlantoaxial arthritis (spondylarthritis C1/C2) with an increased lever arm. Furthermore, a few of the odontoid fractures are accompanied by an atlas fracture resulting in the "atlantoaxial unhappy triad". Posterior C1/C2 spondylodesis with bilateral Magerl screws and C1 hooks is a strong biomechanical construct, however, the posterior approach is associated with several drawbacks such as increased risk of infection and increased blood loss...
October 2015: Zeitschrift Für Orthopädie und Unfallchirurgie
James Coyle
Many patients survive severe stroke because of aggressive management in intensive care units. However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP), a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux...
2012: International Journal of Telerehabilitation
Katia Alonso Rodrigues, Flávia Ribeiro Machado, Brasília Maria Chiari, Heloísa Baccaro Rosseti, Paula Lorenzon, Maria Inês Rebelo Gonçalves
OBJECTIVE: The aim of the present study was to assess the feasibility of the early implementation of a swallowing rehabilitation program in tracheostomized patients under mechanical ventilation with dysphagia. METHODS: This prospective study was conducted in the intensive care units of a university hospital. We included hemodynamically stable patients under mechanical ventilation for at least 48 hours following 48 hours of tracheostomy and with an appropriate level of consciousness...
January 2015: Revista Brasileira de Terapia Intensiva
Shailesh Puntambekar, Rahul Kenawadekar, Sanjay Kumar, Saurabh Joshi, Geetanjali Agarwal, Sunil Reddy, Jainul Mallik
BACKGROUND: We have initially published our experience with the robotic transthoracic esophagectomy in 32 patients from a single institute. The present paper is the extension of our experience with robotic system and to best of our knowledge this represents the largest series of robotic transthoracic esophagectomy worldwide. The objective of this study was to investigate the feasibility of the robotic transthoracic esophagectomy for esophageal cancer in a series of patients from a single institute...
2015: BMC Surgery
Inga K Teismann, Christian Oelschläger, Nicola Werstler, Catharina Korsukewitz, Jens Minnerup, E B Ringelstein, Rainer Dziewas
BACKGROUND: An increasing number of stroke patients have to be supported by mechanical ventilation in intensive care units (ICU), with a relevant proportion of them requiring gradual withdrawal from a respirator. To date, weaning studies have focused merely on mixed patient groups, COPD patients or patients after cardiac surgery. Therefore, the best weaning strategy for stroke patients remains to be determined. METHODS: Here, we designed a prospective randomized controlled study comparing adaptive support ventilation (ASV), a continuous weaning strategy, with biphasic positive airway pressure (BIPAP) in combination with spontaneous breathing trials, a discontinuous technique, in the treatment of stroke patients...
2015: Cerebrovascular Diseases
Molly Kallesen, Alex Psirides, Maggie-Lee Huckabee
PURPOSE: This study aims to evaluate the effect of intubation for coronary artery bypass grafting (CABG) on the cough reflex, an important airway protection mechanism. MATERIALS: Eighty-six participants (70 males) underwent cough reflex texting (CRT) before intubation for CABG to establish baseline threshold for reflexive cough. Cough reflex texting was repeated within 2 hours of extubation and every morning and evening thereafter until the participant coughed at baseline level, withdrew, or was discharged from hospital...
August 2015: Journal of Critical Care
Anette Barbre Pedersen, Annette Kjærsgaard, Jens Kjærgaard Rolighed Larsen, Lars Hedemann Nielsen
Neurogenic oropharyngeal dysphagia (NOD) is a frequent condition in neurological patients admitted to the ICU, particularly in patients with brainstem lesions. The CNS damage itself can predispose to dysphagia, but also the treatment and preventive measures may predispose to and exacerbate the condition. Frequent pneumonia in a neurological patient is a warning signal that should cause screening for dysphagia. Complications are serious and can be fatal. Neurological patients should be examined for NOD before decannulation...
March 2, 2015: Ugeskrift for Laeger
Emilie Bequignon, Tu Anh Duong, Emilie Sbidian, Laurence Valeyrie-Allanore, Saskia Ingen-Housz-Oro, Veronique Chatelin, André Coste, Pierre Wolkenstein, Olivier Chosidow, Jean François Papon
IMPORTANCE: Ear, nose, and throat (ENT) lesions are frequently involved in Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN), although a detailed description is lacking in the literature. OBJECTIVES: To describe ENT lesions at the acute stage and follow-up in a large series of patients with SJS/TEN and identify factors associated with the severe ENT form. DESIGN, SETTING, AND PARTICIPANTS: Retrospective study of 49 patients with SJS/TEN hospitalized in a referral care center from 2005 to 2010...
March 2015: JAMA Dermatology
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
Michael R England, Marissa A Schwartz, Daniel Flis, Brian Kelly, Richard O Wein
We describe a patient who developed a hypopharyngeal mass (in the setting of a cervical osteophyte) while taking clopidogrel and aspirin for coronary artery disease. He had a 2-month history of progressive dysphagia and hoarseness. Physical examination and computed tomography scan revealed a soft tissue retropharyngeal mass of unclear etiology yet with a stable airway. He was admitted to the intensive care unit for a 48-hour clopidogrel washout followed by surgery. A hematoma and cervical osteophyte were removed with scant bleeding...
November 1, 2014: A & A Case Reports
Andrea Kleindienst, Francisco Marin, Frank Dodoo-Schittko
No abstract text is available yet for this article.
February 2015: Critical Care Medicine
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