Fiberoptic Endoscopic Evaluation of Swallow (FEES) in Intensive Care Unit Patients Post Extubation

Area of Science:

• Critical Care Medicine
• Otolaryngology
• Gastroenterology

Background:

• Intensive care unit (ICU) patients frequently require prolonged mechanical ventilation.
• Prolonged intubation can lead to swallowing dysfunction, laryngeal injury, and increased oropharyngeal secretions post-extubation.

Purpose of the Study:

• To evaluate the anatomical damage caused by intubation.
• To assess the occurrence of aspiration and silent aspiration in patients after extubation.
• To utilize fiberoptic endoscopic evaluation of swallow (FEES) as a diagnostic and therapeutic tool.

Main Methods:

• FEES was performed on 41 adult ICU patients intubated for at least 48 hours.
• Patients with head injury, abnormal neurological status, or disorientation were excluded.
• Swallowing function was assessed using FEES, with repeat evaluations after therapy for patients with aspiration.

Main Results:

• 44% (19/41) of patients exhibited laryngeal injury.
• 14% (6/41) of patients experienced aspiration.
• All patients who aspirated had some degree of laryngeal injury.
• A significant correlation was found between the duration of intubation and the incidence of laryngeal injury.

Conclusions:

• Intubation significantly impacts the occurrence of aspiration and laryngeal abnormalities in ICU patients.
• FEES is an effective tool for diagnosing and managing post-extubation swallowing dysfunction.
• Swallowing therapy following FEES can lead to full recovery of swallowing function in patients with aspiration.