The Impact of Swallowing Training on Patients with Post-extubation Dysphagia after Endotracheal Intubation in the...

Post-extubation dysphagia (PED) in ICU patients can delay oral intake, prolong mechanical ventilation, and extend ICU stays. Despite its impact, evidence-based standard procedures for swallowing rehabilitation are lacking. This study aimed to investigate the benefits of a swallowing training program in patients with PED in the ICU. This quasi-experimental study was conducted from January to September 2024 and ICU units were randomly assigned to either a control group or an intervention group. The former were given routine rehabilitation care, whereas the latter received a swallowing training program to investigate best-evidence clinical practice, targeted enhancements were implemented for critical components with suboptimal adherence in swallowing screening and management protocols. Applying the swallowing training program to the intervention group, which included screening for dysphagia, indirect training (basic training), direct training (ingestion training), and the management of complications, for 14 days of intervention. Compared with those of the control group, the swallowing function (MD, 95% CI [2.13(0.27,3.98)], P = 0.025), functional oral intake (MD, 95% CI [1.05(0.29,1.81), P = 0.008), nasogastric tube removal (Log-rank P = 0.013; Cox HR = 0.51, 95% CI: 0.28-0.93, P = 0.028), and incidence of aspiration (P = 0.014) of patients in the intervention group significantly improved, while nutritional indicators did not significantly improve (P > 0.05). The results of this study demonstrated the effectiveness of using a swallowing training program for improving swallowing function, reducing the days of gastric tube retention and complication rates in ICU patients with PED. The results of this study provided evidence to promote early rehabilitation in critically ill patients.