Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours?

Ann Otol Rhinol Laryngol. 2019 Jul;128(7):619-624. doi: 10.1177/0003489419836115. Epub 2019 Mar 6.

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.

Keywords: deglutition; deglutition disorders; extubation; intensive care unit; oral alimentation; swallowing assessment.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Airway Extubation*
  • Deglutition Disorders / diagnosis*
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Prospective Studies
  • Respiration, Artificial
  • Respiratory Insufficiency / therapy
  • Speech-Language Pathology / methods*
  • Time Factors
  • Young Adult