Strategies of Screening and Treating Post-extubation Dysphagia: An Overview of the Situation in Greek-Cypriot ICUs

Abstract

Post-extubation dysphagia (PED) can lead to serious health problems in critical ill patients, yet routine bedside screening may be lacking in many Intensive Care Units (ICUs), possibly due to limited awareness for this condition. This study aimed to establish baseline data on the current approaches, the status of perceived best practices to PED screening and treatment, as well as to assess awareness of PED. A nationwide cross-sectional, online survey was conducted of all adult ICUs in the Republic of Cyprus in June 2018. More than 85% of ICUs reported that there was no standard protocol indicating which patients should be screened for PED. Cough reflex testing and water swallow test were the most reported assessment methods used to confirm the presence of PED. Muscle strengthening exercises without swallowing and swallowing exercises were mostly used to treat dysphagia. Overall, 28.6% of the ICUs agreed that PED was common in their unit. We identified gaps in Greek Cypriot ICUs awareness and knowledge regarding PED screening and treatment. Comprehensive unit-based dysphagia education programs must be urgently im-plemented and interdisciplinary and collaborative work between nurses, intensivists and speech and language therapists is needed to address the situation and improve the quality of care pro-vided.