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
1 Department of Surgery, Section of Otolaryngology, Yale School of Medicine, New Haven, CT, USA.
2 Southern Connecticut State University, New Haven, CT, USA.
Ann Otol Rhinol Laryngol. 2019 Jul;128(7):619-624. doi: 10.1177/0003489419836115. Epub 2019 Mar 6.
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.
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).
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.
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.
拔管后吞咽困难与医院获得性肺炎发病率增加、住院时间延长和再插管率升高有关。本研究的目的是确定拔管后是否有必要延迟24小时进行吞咽功能评估。
在拔管后1小时、4小时和24小时对吞咽情况进行前瞻性调查，以确定插管后是否有必要延迟吞咽功能评估。研究对象为来自5个不同重症监护病房（ICU）的202名成年人。
202名患者中共有166名（82.2%）在拔管后1小时通过了耶鲁吞咽方案评估，4小时时又有11名（177/202；87.6%）通过，24小时时再有8名（185/202；91.6%）通过。只有插管持续时间≥4天与吞咽功能障碍显著相关。
我们发现对于拔管后的患者没有必要延迟吞咽功能评估。具体而言，我们研究中的大多数患者（82.2%）在拔管后1小时通过了吞咽筛查。
