Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours?

Autor:	Leder SB; 1 Department of Surgery, Section of Otolaryngology, Yale School of Medicine, New Haven, CT, USA., Warner HL; 2 Southern Connecticut State University, New Haven, CT, USA., Suiter DM; 3 University of Kentucky, Lexington, KY, USA., Young NO; 1 Department of Surgery, Section of Otolaryngology, Yale School of Medicine, New Haven, CT, USA., Bhattacharya B; 4 Department of Surgery, Section of Trauma, Surgical Critical Care, and Surgical Emergencies, Yale School of Medicine, New Haven, CT, USA., Siner JM; 5 Department of Internal Medicine, Section of Pulmonary, Critical Care, & Sleep Medicine, Yale School of Medicine, New Haven, CT, USA., Davis KA; 4 Department of Surgery, Section of Trauma, Surgical Critical Care, and Surgical Emergencies, Yale School of Medicine, New Haven, CT, USA., Maerz LL; 4 Department of Surgery, Section of Trauma, Surgical Critical Care, and Surgical Emergencies, Yale School of Medicine, New Haven, CT, USA., Rosenbaum SH; 6 Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA., Marshall PS; 5 Department of Internal Medicine, Section of Pulmonary, Critical Care, & Sleep Medicine, Yale School of Medicine, New Haven, CT, USA., Pisani MA; 7 Department of Pulmonary Critical Care & Sleep Medicine, Yale School of Medicine, New Haven, CT, USA., Siegel MD; 5 Department of Internal Medicine, Section of Pulmonary, Critical Care, & Sleep Medicine, Yale School of Medicine, New Haven, CT, USA., Brennan JJ; 8 Department of Cardiology, Yale School of Medicine, New Haven, CT, USA., Schuster KM; 4 Department of Surgery, Section of Trauma, Surgical Critical Care, and Surgical Emergencies, Yale School of Medicine, New Haven, CT, USA.
Jazyk:	angličtina
Zdroj:	The Annals of otology, rhinology, and laryngology [Ann Otol Rhinol Laryngol] 2019 Jul; Vol. 128 (7), pp. 619-624. Date of Electronic Publication: 2019 Mar 06.
DOI:	10.1177/0003489419836115
Abstrakt:	Background: Post-extubation dysphagia is associated with an increased incidence of nosocomial pneumonias, longer hospitalizations, and higher re-intubation rates. The purpose of this study was to determine if it is necessary to delay swallow evaluation for 24 hours post-extubation. Methods: A prospective investigation of swallowing was conducted at 1, 4, and 24 hours post-extubation to determine if it is necessary to delay swallow evaluation following intubation. Participants were 202 adults from 5 different intensive care units (ICU). Results: A total of 166 of 202 (82.2%) passed the Yale Swallow Protocol at 1 hour post-extubation, with an additional 11 (177/202; 87.6%) at 4 hours, and 8 more (185/202; 91.6%) at 24 hours. Only intubation duration ≥4 days was significantly associated with nonfunctional swallowing. Conclusions: We found it is not necessary to delay assessment of swallowing in individuals who are post-extubation. Specifically, the majority of patients in our study (82.2%) passed a swallow screening at 1 hour post-extubation.
Databáze:	MEDLINE
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