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Routine fiberoptic endoscopic evaluation of swallowing following prolonged intubation: implications for management
M S Ajemian1, G B Nirmul, M T Anderson
1Department of Surgery, Waterbury Hospital Health Center, 64 Robbins St, Waterbury, CT 06721, USA. majemian@wtbyhosp.chime.org
Archives of Surgery (Chicago, Ill. : 1960)
|May 5, 2001
Summary
Fiberoptic endoscopic evaluation of swallowing (FEES) identified high aspiration risk in over 50% of patients after prolonged intubation. Tailored dietary changes effectively prevented aspiration pneumonia, highlighting FEES
Area of Science:
- Medicine
- Otolaryngology
- Critical Care
Background:
- Prolonged intubation can lead to swallowing dysfunction and pulmonary aspiration.
- Early identification of aspiration risk is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the utility of Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in identifying patients at high risk for aspiration after prolonged intubation.
- To assess the effectiveness of FEES-guided dietary recommendations in preventing clinically significant aspiration.
Main Methods:
- Bedside FEES was performed on 51 patients intubated for at least 48 hours within 48 hours of extubation.
- Swallowing function was assessed, and dietary recommendations were made based on FEES findings.
- Patients were monitored for signs of aspiration and clinical outcomes.
Main Results:
- Swallowing dysfunction was identified in 56% of patients, with 25% being silent aspirators.
- Aspiration occurred primarily with thin liquids (70%) and purees (30%).
- No patients developed clinically significant aspiration when following modified diet recommendations.
Conclusions:
- FEES is effective in detecting swallowing dysfunction and silent aspiration in patients post-prolonged intubation.
- FEES-guided dietary modifications are crucial in preventing aspiration and its complications.