Pharyngo-esophago-gastric dysmotility in intubated patients: A comprehensive review

Postextubation swallowing dysfunction is a common phenomenon within the pharyngo-esophago-gastric dysmotility disorders. It is commonly seen after major surgery which requires endotracheal intubation for mechanical ventilation and associated with pulmonary complications which may lead to increased morbidity and mortality, prolonged hospital stay and increased cost. Thus, understanding the underlying mechanism of this phenomenon is crucial for early recognition and diagnosis of this entity, and to take preventive measures to minimize associated complications and morbidity. Literature search of the Medline database was performed to obtain related studies discussing pharyngo-esophago-gastric dysmotility. We focused on studies including PSD following major surgery and extracted data from the relevant studies, compared results, and summarized the related information. We reviewed the underlying mechanism, available diagnostic tools, risk factors, major pulmonary complications and their consequences, basic preventive measures and potential solutions related to this entity and aimed to guide physicians through decision-making process for their individual patients.