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拔管后吞咽困难的筛查与治疗策略:希族塞人重症监护病房情况概述

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

作者信息

Mpouzika Meropi, Iordanou Stelios, Kyranou Maria, Iliopoulou Katerina, Parissopoulos Stelios, Kalafati Maria, Karanikola Maria, Papathanassoglou Elizabeth

机构信息

Department of Nursing, School of Health Sciences, Cyprus University of Technology, 3041 Limassol, Cyprus.

Limassol General Hospital, State Health Services Organization, 4131 Limassol, Cyprus.

出版信息

Healthcare (Basel). 2023 Aug 13;11(16):2283. doi: 10.3390/healthcare11162283.

Abstract

Post-extubation dysphagia (PED) can lead to serious health problems in critically ill patients. Contrasting its high incidence rate of 12.4% reported in a recent observational study, many ICUs lack routine bedside screening, likely due to limited awareness. This study aimed to establish baseline data on the current approaches and the status of perceived best practices in PED screening and treatment, as well as to assess awareness of PED. A nationwide cross-sectional, online survey was conducted in all fourteen adult ICUs in the Republic of Cyprus in June 2018, with a 100% response rate. Over 85% of ICUs lacked a standard screening protocol for PED. The most commonly reported assessment methods were cough reflex testing and the water swallow test. Treatment approaches included muscle strengthening exercises without swallowing and swallowing exercises. Only 28.6% of ICUs acknowledged PED as a common issue. The study identified significant gaps in awareness and knowledge regarding PED screening and treatment in Greek-Cypriot ICUs. Urgent implementation of comprehensive dysphagia education programs within the units is necessary, and interdisciplinary collaboration among nurses, intensivists, and speech and language therapists is crucial to improve the quality of care provided.

摘要

拔管后吞咽困难(PED)可导致重症患者出现严重的健康问题。近期一项观察性研究报告显示其发病率高达12.4%,形成反差的是,许多重症监护病房(ICU)缺乏常规的床边筛查,这可能是由于认知有限所致。本研究旨在建立关于PED筛查和治疗的当前方法及最佳实践认知现状的基线数据,并评估对PED的认知情况。2018年6月,在塞浦路斯共和国所有14个成人ICU中进行了一项全国性横断面在线调查,回复率达100%。超过85%的ICU缺乏PED标准筛查方案。最常报告的评估方法是咳嗽反射测试和水吞咽试验。治疗方法包括不涉及吞咽的肌肉强化锻炼和吞咽锻炼。只有28.6%的ICU承认PED是一个常见问题。该研究发现希族塞人ICU在PED筛查和治疗的认知及知识方面存在显著差距。各单位迫切需要实施全面的吞咽困难教育计划,护士、重症监护医生以及言语和语言治疗师之间的跨学科合作对于提高所提供的护理质量至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b32d/10454777/4d8604ee16d5/healthcare-11-02283-g001.jpg

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