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Swallowing dysfunction following endotracheal intubation: Age matters

To evaluate postextubation swallowing dysfunction (PSD) 21 days after endotracheal extubation and to examine whether PSD is time-limited and whether age matters. For this prospective cohort study, we evaluated 151 adult critical care patients (≥20 years) who were intubated for at least 48 hours and...

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Autores principales: Tsai, Min-Hsuan, Ku, Shih-Chi, Wang, Tyng-Guey, Hsiao, Tzu-Yu, Lee, Jang-Jaer, Chan, Ding-Cheng, Huang, Guan-Hua, Chen, Cheryl Chia-Hui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998458/
https://www.ncbi.nlm.nih.gov/pubmed/27310972
http://dx.doi.org/10.1097/MD.0000000000003871
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author Tsai, Min-Hsuan
Ku, Shih-Chi
Wang, Tyng-Guey
Hsiao, Tzu-Yu
Lee, Jang-Jaer
Chan, Ding-Cheng
Huang, Guan-Hua
Chen, Cheryl Chia-Hui
author_facet Tsai, Min-Hsuan
Ku, Shih-Chi
Wang, Tyng-Guey
Hsiao, Tzu-Yu
Lee, Jang-Jaer
Chan, Ding-Cheng
Huang, Guan-Hua
Chen, Cheryl Chia-Hui
author_sort Tsai, Min-Hsuan
collection PubMed
description To evaluate postextubation swallowing dysfunction (PSD) 21 days after endotracheal extubation and to examine whether PSD is time-limited and whether age matters. For this prospective cohort study, we evaluated 151 adult critical care patients (≥20 years) who were intubated for at least 48 hours and had no pre-existing neuromuscular disease or swallowing dysfunction. Participants were assessed for time (days) to pass bedside swallow evaluations (swallow 50 mL of water without difficulty) and to resume total oral intake. Outcomes were compared between younger (20–64 years) and older participants (≥65 years). PSD, defined as inability to swallow 50 mL of water within 48 hours after extubation, affected 92 participants (61.7% of our sample). At 21 days postextubation, 17 participants (15.5%) still failed to resume total oral intake and were feeding-tube dependent. We found that older participants had higher PSD rates at 7, 14, and 21 days postextubation, and took significantly longer to pass the bedside swallow evaluations (5.0 vs 3.0 days; P = 0.006) and to resume total oral intake (5.0 vs 3.0 days; P = 0.003) than their younger counterparts. Older participants also had significantly higher rates of subsequent feeding-tube dependence than younger patients (24.1 vs 5.8%; P = 0.008). Excluding patients with pre-existing neuromuscular dysfunction, PSD is common and prolonged. Age matters in the time needed to recover. Swallowing and oral intake should be monitored and interventions made, if needed, in the first 7 to 14 days postextubation, particularly for older patients.
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spelling pubmed-49984582016-09-02 Swallowing dysfunction following endotracheal intubation: Age matters Tsai, Min-Hsuan Ku, Shih-Chi Wang, Tyng-Guey Hsiao, Tzu-Yu Lee, Jang-Jaer Chan, Ding-Cheng Huang, Guan-Hua Chen, Cheryl Chia-Hui Medicine (Baltimore) 4600 To evaluate postextubation swallowing dysfunction (PSD) 21 days after endotracheal extubation and to examine whether PSD is time-limited and whether age matters. For this prospective cohort study, we evaluated 151 adult critical care patients (≥20 years) who were intubated for at least 48 hours and had no pre-existing neuromuscular disease or swallowing dysfunction. Participants were assessed for time (days) to pass bedside swallow evaluations (swallow 50 mL of water without difficulty) and to resume total oral intake. Outcomes were compared between younger (20–64 years) and older participants (≥65 years). PSD, defined as inability to swallow 50 mL of water within 48 hours after extubation, affected 92 participants (61.7% of our sample). At 21 days postextubation, 17 participants (15.5%) still failed to resume total oral intake and were feeding-tube dependent. We found that older participants had higher PSD rates at 7, 14, and 21 days postextubation, and took significantly longer to pass the bedside swallow evaluations (5.0 vs 3.0 days; P = 0.006) and to resume total oral intake (5.0 vs 3.0 days; P = 0.003) than their younger counterparts. Older participants also had significantly higher rates of subsequent feeding-tube dependence than younger patients (24.1 vs 5.8%; P = 0.008). Excluding patients with pre-existing neuromuscular dysfunction, PSD is common and prolonged. Age matters in the time needed to recover. Swallowing and oral intake should be monitored and interventions made, if needed, in the first 7 to 14 days postextubation, particularly for older patients. Wolters Kluwer Health 2016-06-17 /pmc/articles/PMC4998458/ /pubmed/27310972 http://dx.doi.org/10.1097/MD.0000000000003871 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 4600
Tsai, Min-Hsuan
Ku, Shih-Chi
Wang, Tyng-Guey
Hsiao, Tzu-Yu
Lee, Jang-Jaer
Chan, Ding-Cheng
Huang, Guan-Hua
Chen, Cheryl Chia-Hui
Swallowing dysfunction following endotracheal intubation: Age matters
title Swallowing dysfunction following endotracheal intubation: Age matters
title_full Swallowing dysfunction following endotracheal intubation: Age matters
title_fullStr Swallowing dysfunction following endotracheal intubation: Age matters
title_full_unstemmed Swallowing dysfunction following endotracheal intubation: Age matters
title_short Swallowing dysfunction following endotracheal intubation: Age matters
title_sort swallowing dysfunction following endotracheal intubation: age matters
topic 4600
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998458/
https://www.ncbi.nlm.nih.gov/pubmed/27310972
http://dx.doi.org/10.1097/MD.0000000000003871
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