Predictive factors for oropharyngeal dysphagia after prolonged orotracheal intubation

Oliveira, Ana Carolina Martins de; Friche, Amélia Augusta de Lima; Salomão, Marina Silva; Bougo, Graziela Chamarelli; Vicente, Laélia Cristina Caseiro

doi:10.1016/j.bjorl.2017.08.010

Cited by 53 publications

(77 citation statements)

References 27 publications

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“…The main reason is due to the impact of cardiopulmonary bypass and intraoperative hypothermia on various organ functions. For the recovery of nutritional support after cardiac surgery in infants, in addition to overcoming the potential injury from cardiopulmonary bypass during the operation and subjection of the gastrointestinal tract to ischemia-reperfusion injury, oropharyngeal injury and swallowing dysfunction caused by tracheal intubation must also be evaluated and treated [ 9 , 10 ]. If feeding disorder after cardiac surgery is avoided, patients can effectively avoid hospital complications caused by the use of total parenteral nutrition, nasogastric tubes, or even fistulas, which can even speed up the patients’ recovery process [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: The effect of early oral stimulation with breast milk on the feeding behavior of infants after congenital cardiac surgery

Huang

et al. 2020

J Cardiothorac Surg

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Objective To investigate the effect of early oral stimulation with breast milk on the feeding behavior of infants after congenital cardiac surgery. Methods Infants with congenital heart disease were randomly divided into the breast milk oral stimulation group (n = 23), physiological saline oral stimulation group (n = 23) and control group (n = 23). Debra Beckman’s oral exercise program was used with breast milk and physiological saline in the breast milk oral stimulation group and the physiological saline oral stimulation group, respectively. The time oral feeding and total oral nutrition were started, the length of intensive care unit (ICU) stay and hospital stay, weight and the complications at discharge were recorded for each group and statistically analyzed. Results The time oral feeding and total oral nutrition were started and the length of ICU stay and hospital stay were significantly less in the breast milk oral stimulation group and physiological saline oral stimulation group than in the control group (P < 0.05). There were no significant differences in other indicators between the breast milk oral stimulation group and the physiological saline oral stimulation group, except for the time total oral nutrition began (P < 0.05). However, there were no significant differences in weight or complications at discharge among the three groups (P > 0.05). Conclusion Early oral stimulation exercises with breast milk can help infant patients quickly recover total oral nutrition and reduce the length of ICU and hospital stay after cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: The effect of early oral stimulation with breast milk on the feeding behavior of infants after congenital cardiac surgery

Huang

et al. 2020

J Cardiothorac Surg

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“…Our study demonstrated the clinical characteristics of PED on the basis of the medical condition for which endotracheal intubation was initiated, and showed quantification of dysfunction in the oral and laryngeal swallowing phases by using VFSS. Previous studies have identified many clinical factors associated with PED, although the results of those studies were controversial [2]; the use of fiberoptic endoscopic evaluations in patients with PED revealed that intubation duration was related to the incidence and severity of PED [1,2,18,19]. In our study, we noted a correlation between the severity of PED, especially the amount of RV, and the severity of clinical illness, similar to the findings of another study [20].…”

Section: Discussionsupporting

confidence: 87%

Association between clinical risk factors and severity of dysphagia after extubation based on a videofluoroscopic swallowing study

Yang

Park

Min

et al. 2020

Korean J Intern Med

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Background/Aims: This study aimed to evaluate the correlation between clinical risk factors of post-extubation dysphagia (PED) and the severity of impaired pharyngeal swallowing function assessed via videofluoroscopic swallowing studies (VFSSs). Methods: This study was a retrospective review of medical records. Of 116 patients who were admitted to the intensive care unit and underwent VFSS, 32 who had non-neurologic disorders and experienced prolonged intubation (for more than 48 hours) were diagnosed with PED. The severity of PED was evaluated by using a functional dysphagia scale (FDS) and a penetration aspiration scale (PAS), on the basis of VFSS. Results: The Simplified Acute Physiology Score 3 and total FDS score were positively correlated (r = 0.40, p = 0.02). Intubation duration was positively correlated with total PAS and FDS scores (r = 0.62, p < 0.001; r = 0.65, p < 0.001, respectively). The amounts of residue in the valleculae (RV) and pyriform sinuses (RP) were associated with intubation duration (r = 0.58, p < 0.001; r = 0.57, p < 0.001, respectively). Multivariate regression analysis revealed that intubation duration was significantly associated with the total FDS score, RV and RP subscales of the FDS, and total PAS score. Conclusions: The severity of impaired swallowing function, particularly the amount of residue in the pharyngeal recesses assessed via VFSS, was strongly associated with both severity of medical illness and intubation duration. Intubation duration could be a prognostic factor for assessing impaired swallowing function on the basis of VFSS.

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“…This reassuring finding will not necessarily carry forward to long-term speech, swallowing, and breathing outcomes given the duration for which COVID-19 patients have had endotracheal and tracheostomy tubes in situ (Fig. 1) [9,43]. Therefore, the high rate of dysphonia that we identified at the first cuff down trial (Table 2) requires further follow-up to determine whether we will see a significant laryngological rehabilitation burden.…”

Section: Laryngotracheal Sequelae Of Covid-19 Airway Managementmentioning

confidence: 94%

Tracheostomy, ventilatory wean, and decannulation in COVID-19 patients

Tornari

Šurda

Takhar

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose COVID-19 patients requiring mechanical ventilation can overwhelm existing bed capacity. We aimed to better understand the factors that influence the trajectory of tracheostomy care in this population to facilitate capacity planning and improve outcomes. Methods We conducted an observational cohort study of patients in a high-volume centre in the worst-affected region of the UK including all patients that underwent tracheostomy for COVID-19 pneumonitis ventilatory wean from 1st March 2020 to 10th May 2020. The primary outcome was time from insertion to decannulation. The analysis utilised Cox regression to account for patients that are still progressing through their tracheostomy pathway. Results At the point of analysis, a median 21 days (IQR 15-28) post-tracheostomy and 39 days (IQR 32-45) post-intubation, 35/69 (57.4%) patients had been decannulated a median of 17 days (IQR 12-20.5) post-insertion. The overall median age was 55 (IQR 48-61) with a male-to-female ratio of 2:1. In Cox regression analysis, FiO 2 at tracheostomy ≥ 0.4 (HR 1.80; 95% CI 0.89-3.60; p = 0.048) and last pre-tracheostomy peak cough flow (HR 2.27; 95% CI 1.78-4.45; p = 0.001) were independent variables associated with prolonged time to decannulation. Conclusion Higher FiO 2 at tracheostomy and higher pre-tracheostomy peak cough flow are associated with increased delay in COVID-19 tracheostomy patient decannulation. These finding comprise the most comprehensive report of COVID-19 tracheostomy decannulation to date and will assist service planning for future peaks of this pandemic.

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Predictive factors for oropharyngeal dysphagia after prolonged orotracheal intubation

Cited by 53 publications

References 27 publications

RETRACTED ARTICLE: The effect of early oral stimulation with breast milk on the feeding behavior of infants after congenital cardiac surgery

RETRACTED ARTICLE: The effect of early oral stimulation with breast milk on the feeding behavior of infants after congenital cardiac surgery

Association between clinical risk factors and severity of dysphagia after extubation based on a videofluoroscopic swallowing study

Tracheostomy, ventilatory wean, and decannulation in COVID-19 patients

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