From the Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland (MBB, MG-F); Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University School of Medicine, Baltimore, Maryland (MBB); Department of Intensive Care Medicine, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands (JLN); and Department of Intensive Care Medicine, Gelre Hospitals, Expertise Center for Intensive Care Rehabilitation Apeldoorn (ExpIRA), Apeldoorn, the Netherlands (PES).
Am J Phys Med Rehabil. 2020 Dec;99(12):1164-1170. doi: 10.1097/PHM.0000000000001440.
Postextubation dysphagia may impose a substantial burden on intensive care unit patients and healthcare systems. Approximately 517,000 patients survive mechanical ventilation during critical care annually. Reports of postextubation dysphagia prevalence are highly variable ranging between 3% and 93%. Of great concern is aspiration leading to the development of aspiration pneumonia when patients resume oral feeding. Screening for aspiration with a water swallow test has been reported to be positive for 12% of patients in the intensive care unit after extubation. This review aims to increase awareness of postextubation dysphagia and provide an updated overview of the current knowledge regarding prevalence, pathophysiology, diagnostic modalities, and treatment options.
拔管后吞咽困难可能会给重症监护病房的患者和医疗系统带来沉重负担。每年大约有 51.7 万名患者在重症监护期间需要接受机械通气治疗。关于拔管后吞咽困难的患病率报告差异很大，范围在 3%至 93%之间。令人担忧的是，当患者恢复经口进食时，会导致吸入而引发吸入性肺炎。有报道称，在拔管后，12%的重症监护病房患者用水吞咽试验呈阳性。本综述旨在提高对拔管后吞咽困难的认识，并提供当前关于患病率、病理生理学、诊断方法和治疗选择的最新知识概述。
