Bedside screen for oral cavity structure, salivary flow, and vocal production over the 14 days following endotracheal extubation
Journal
Journal of Critical Care
Journal Volume
45
Pages
1-6
Date Issued
2018
Author(s)
Abstract
Purpose: To describe the sequelae of oral endotracheal intubation by evaluating prevalence rates of structural injury, hyposalivation, and impaired vocal production over 14 days following extubation. Materials and methods: Consecutive adults (? 20 years, N = 114) with prolonged (? 48 h) endotracheal intubation were enrolled from medical intensive care units at a university hospital. Participants were assessed by trained nurses at 2, 7, and 14 days after extubation, using a standardized bedside screening protocol. Results: Within 48-hour postextubation, structural injuries were common, with 51% having restricted mouth opening. Unstimulated salivary flow was reduced in 43%. For vocal production, 51% had inadequate breathing support for phonation, dysphonia was common (94% had hoarseness and 36% showed reduced efficiency of vocal fold closure), and > 40% had impaired articulatory precision. By 14 days postextubation, recovery was noted in most conditions, but reduced efficiency of vocal fold closure persisted. Restricted mouth opening (39%) and reduced salivary flow (34%) remained highly prevalent. Conclusions: After extubation, restricted mouth opening, reduced salivary flow, and dysphonia were common and prolonged in recovery. Reduced efficiency of vocal cord closure persisted at 14 days postextubation. The extent and duration of these sequelae remind clinicians to screen for them up to 2 weeks after extubation. ? 2017 Elsevier Inc.
SDGs
Other Subjects
adult; Article; clinical protocol; convalescence; disease duration; disease severity; dysphonia; endotracheal intubation; extubation; female; hoarseness; human; hyposalivation; major clinical study; male; medical intensive care unit; middle aged; motor performance; mouth cavity; mouth injury; mouth ulcer; patient assessment; phonation; pilot study; prevalence; prospective study; salivation; speech sound disorder; temporomandibular joint disorder; university hospital; vocal cord disorder; vocalization; aged; dysphonia; extubation; injuries; intensive care; pathophysiology; point of care testing; statistics and numerical data; time factor; vocal cord; xerostomia; Adult; Aged; Airway Extubation; Critical Care; Dysphonia; Female; Humans; Male; Middle Aged; Pilot Projects; Point-of-Care Testing; Prospective Studies; Time Factors; Vocal Cords; Xerostomia
Publisher
W.B. Saunders
Type
journal article