Laryngeal Competence after Tracheal Extubation

Burgess, G. E.; Cooper, John R.; Marino, Robert J.; Peuler, Martin J.; Warriner, Robert A.

doi:10.1097/00132586-198006000-00026

Cited by 6 publications

(7 citation statements)

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“…Inhibition of the sensory larynx abilities led to the absence of coughing or any other behavioral aspiration signs in patients following liquid bolus ingestion. Furthermore, this effect was observed immediately and 4 hours following extubation, and the detrimental effects were significantly reduced within 8 hours post-extubation (34). Additionally, most mucosal lesions caused by orotracheal tubes are healed 3 days following extubation (35).…”

Section: Discussionmentioning

confidence: 99%

Clinical dysphagia risk predictors after prolonged orotracheal intubation

Medeiros¹,

Sassi²,

Mangilli³

et al. 2014

Clinics

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OBJECTIVES:To elucidate independent risk factors for dysphagia after prolonged orotracheal intubation.METHODS:The participants were 148 consecutive patients who underwent clinical bedside swallowing assessments from September 2009 to September 2011. All patients had received prolonged orotracheal intubations and were admitted to one of several intensive care units of a large Brazilian school hospital. The correlations between the conducted water swallow test results and dysphagia risk levels were analyzed for statistical significance.RESULTS:Of the 148 patients included in the study, 91 were male and 57 were female (mean age, 53.64 years). The univariate analysis results indicated that specific variables, including extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking, and other signs, were possible significant high-risk indicators of dysphagia onset. The multivariate analysis results indicated that cervical auscultation and coughing were independent predictive variables for high dysphagia risk.CONCLUSIONS:Patients displaying extraoral loss, multiple swallows, cervical auscultation, vocal quality, cough, choking and other signs should benefit from early swallowing evaluations. Additionally, early post-extubation dysfunction recognition is paramount in reducing the morbidity rate in this high-risk population.

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Section: Discussionmentioning

confidence: 99%

Clinical dysphagia risk predictors after prolonged orotracheal intubation

Medeiros¹,

Sassi²,

Mangilli³

et al. 2014

Clinics

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“…There is no agreement in the literature as to what constitutes long-term intubation, with reports of durations as short as 8 hours 3 to durations of 1, 4 2, 5,6 or 7 days. 2 There is also no consensus regarding when to evaluate swallowing post-extubation, with some studies advocating for immediate testing 7,8 and others recommending waiting from 1 day 2 to 5 days. 9 Endotracheal intubation per se is not causative for iatrogenic swallowing problems, and no specific post-extubation swallowing risk factors have been identified due to the heterogeneity in methodology of the post-extubation swallowing literature.…”

Section: Introductionmentioning

confidence: 99%

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

Leder

Warner

Suiter

et al. 2019

Ann Otol Rhinol Laryngol

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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.

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“…Laryngeal function may be disturbed for at least 4 hours after tracheal extubation. 45 Immediately following extubation, 8 of 24 (33%) patients aspirated swallowed radiopaque dye; five showed radiologic evidence of massive aspiration. Four hours following extubation, 4 of 20 (20%) patients aspirated, 3 massively.…”

Section: K Airway Obstruction-preexisting Medical Conditionsmentioning

confidence: 98%

“…178 In both series, the ETVC 62 and the CAEC, 178 respectively, had been used mostly to maintain airway access. The ETVC was also used for oxygen insufflation (31 patients), jet ventilation (45), and postextubation capnography (54).…”

Section: Endotracheal Ventilation Catheter*mentioning

confidence: 99%

Extubation and Changing Endotracheal Tubes

Cooper¹

2007

Benumof's Airway Management

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Laryngeal Competence after Tracheal Extubation

Cited by 6 publications

References 0 publications

Clinical dysphagia risk predictors after prolonged orotracheal intubation

Clinical dysphagia risk predictors after prolonged orotracheal intubation

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

Extubation and Changing Endotracheal Tubes

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