Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours?. (July 2019)

• Record Type: Journal Article
• Authors: Leder, Steven B.; Warner, Heather L.; Suiter, Debra M.; Young, Nwanmegha O.; Bhattacharya, Bishwajit; Siner, Jonathan M.; Davis, Kimberly A.; Maerz, Linda L.; Rosenbaum, Stanley H.; Marshall, Peter S.; Pisani, Margaret A.; Siegel, Mark D.; Brennan, Joseph J.; Schuster, Kevin M.
• Is Part Of: Annals of otology, rhinology & laryngology. Volume 128:Number 7(2019)
• Page Start: 619
• Page End: 624
• Publication Date: 2019-07
• Subjects: deglutition -- deglutition disorders -- swallowing assessment -- extubation -- oral alimentation -- intensive care unit; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0003489419836115
• Languages: English
• ISSNs: 0003-4894

Abstract

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.