Related Experiment Video
Updated: Dec 13, 2025
Adapting Human Videofluoroscopic Swallow Study Methods to Detect and Characterize Dysphagia in Murine Disease Models
Published on: March 1, 2015
Post-extubation dysphagia incidence in critically ill patients: A systematic review and meta-analysis
Melanie McIntyre1, Sebastian Doeltgen2, Nathan Dalton3
1Swallowing Neurorehabilitation Research Lab, Speech Pathology, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia; Bendigo Health, Department of Speech Pathology, GPO Box 126, Bendigo, Victoria, 3552, Australia.
Background:
Post-extubation dysphagia has been associated with adverse health outcomes. To assist service planning and process development for early identification, an understanding of the number of patients affected is required. However, significant variation exists in the reported incidence which ranges from 3% to 62%.
Objectives:
The objective of this study was to (i) conduct a meta-analysis on the incidence of dysphagia after endotracheal intubation in adult critically ill patients and (ii) describe the extent of heterogeneity within peer-reviewed articles and grey literature on the incidence of dysphagia after endotracheal intubation.
Data Sources:
Databases CINAHL, Cochrane Library, Embase, MEDLINE, PubMed, SpeechBITE, and Google Scholar were systematically searched for studies published before October 2019.
Review Methods:
Data extraction occurred in a double-blind manner for studies meeting the inclusion criteria. Risk of bias was determined using critical appraisal tools relevant to the individual study design. The overall quality of the synthesised results was described using the Grading of Recommendations Assessment, Development and Evaluation methodology. Raw data were transformed using Freeman-Tukey arcsine square root methodology. A random-effects model was utilised owing to heterogeneity between studies.
Results:
Of 3564 identified studies, 38 met the criteria for inclusion in the final review. A total of 5798 patient events were analysed, with 1957 dysphagic episodes identified. The combined weighted incidence of post-extubation dysphagia was 41% (95% confidence interval, 0.33-0.50). Of the patients with dysphagia, 36% aspirated silently (n = 155, 95% confidence interval, 0.22-0.50). Subgroup meta-regression analysis was unable to explain the heterogeneity across studies when accounting for the method of participant recruitment, method of dysphagia assessment, median duration of intubation, timing of dysphagia assessment, or patient population.
Conclusion:
Dysphagia after endotracheal intubation is common and occurs in 41% of critically ill adults. Given the prevalence of dysphagia and high rates of silent aspiration in this population, further prospective research should focus on systematic and sensitive early identification methods.
Related Concept Videos
01:24Endotracheal Tube Extubation
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
01:17Endotracheal Intubation II: Nursing Management
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:15Endotracheal Intubation I: Procedure
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...