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Postextubation Dysphagia.

Supannee Rassameehiran1, Saranapoom Klomjit1, Charoen Mankongpaisarnrung1

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Postextubation dysphagia (PED) is common after intubation. While some factors reduce risk, current treatments like diet changes have limited benefits, suggesting a need for direct oromotor therapies.

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Area of Science:

  • Critical Care Medicine
  • Neurology
  • Gastroenterology

Background:

  • Postextubation dysphagia (PED) frequently affects critically ill patients following mechanical ventilation.
  • Identified risk factors for PED are often nonmodifiable preexisting or concurrent conditions.
  • Existing treatments for PED show limited proven benefits.

Purpose of the Study:

  • To review the current understanding of postextubation dysphagia.
  • To evaluate the diagnostic accuracy of bedside swallow evaluations versus instrumental tests.
  • To explore the efficacy of current and potential future treatments for PED.

Main Methods:

  • Literature review of studies on postextubation dysphagia.
  • Analysis of risk factors, diagnostic methods, and treatment strategies.
  • Evaluation of evidence for dietary modifications, compensatory maneuvers, and direct therapies.

Main Results:

  • Nonmodifiable factors contribute significantly to PED risk.
  • Bedside swallow evaluations have uncertain diagnostic accuracy compared to instrumental tests.
  • Current treatments like dietary changes and maneuvers offer limited benefits.

Conclusions:

  • Early extubation and smaller tube sizes may reduce PED risk.
  • Instrumental swallowing assessments are crucial for accurate diagnosis and individualized treatment.
  • Direct oromotor therapies, including exercises and neuromuscular stimulation, show promise as effective PED treatments.