Swallowing dysfunction following endotracheal intubation: Age matters

Area of Science:

• Critical Care Medicine
• Neurology
• Geriatrics

Background:

• Postextubation swallowing dysfunction (PSD) is a potential complication following mechanical ventilation.
• Understanding the incidence, duration, and risk factors for PSD is crucial for patient recovery.

Purpose of the Study:

• To evaluate the incidence and time course of PSD up to 21 days postextubation.
• To determine if age influences the recovery trajectory of swallowing function and oral intake.
• To examine the long-term consequences of PSD, including feeding-tube dependence.

Main Methods:

• Prospective cohort study of 151 adult patients (≥20 years) intubated for ≥48 hours.
• Assessment of time to pass bedside swallow evaluations and resume total oral intake.
• Comparison of outcomes between younger (20-64 years) and older (≥65 years) patient groups.

Main Results:

• PSD affected 61.7% of patients within 48 hours of extubation.
• At 21 days, 15.5% of patients remained feeding-tube dependent.
• Older participants showed higher PSD rates and significantly longer recovery times for swallowing and oral intake compared to younger patients.

Conclusions:

• PSD is a common and prolonged issue in critical care survivors without pre-existing neuromuscular disease.
• Age is a significant factor influencing the duration of PSD and recovery of oral intake.
• Early monitoring and intervention for swallowing difficulties, especially in older patients, are recommended within the first 7-14 days postextubation.