https://scholars.lib.ntu.edu.tw/handle/123456789/483512
標題: | Effects of a swallowing and oral care intervention for patients following endotracheal extubation: A pre- A nd post-intervention study | 作者: | Wu C.-P. Xu Y.-J. TYNG-GUEY WANG SHIH-CHI KU DING-CHENG CHAN JANG-JAER LEE Wei Y.-C. Hsiao T.-Y. CHERYL CHIA-HUI CHEN |
公開日期: | 2019 | 出版社: | BioMed Central Ltd. | 卷: | 23 | 期: | 1 | 起(迄)頁: | 350 | 來源出版物: | Critical Care | 摘要: | Background: For patients who survive a critical illness and have their oral endotracheal tube removed, dysphagia is highly prevalent, and without intervention, it may persist far beyond hospital discharge. This pre- A nd post-intervention study with historical controls tested the effects of a swallowing and oral care (SOC) intervention on patients' time to resume oral intake and salivary flow following endotracheal extubation. Methods: The sample comprised intensive care unit patients (? 50 years) successfully extubated after ? 48 h endotracheal intubation. Participants who received usual care (controls, n = 117) were recruited before 2015, and those who received usual care plus the intervention (n = 54) were enrolled after 2015. After extubation, all participants were assessed by a blinded nurse for daily intake status (21 days) and whole-mouth unstimulated salivary flow (2, 7, 14 days). The intervention group received the nurse-administered SOC intervention, comprising toothbrushing/salivary gland massage, oral motor exercise, and safe-swallowing education daily for 14 days or until hospital discharge. Results: The intervention group received 8.3 ± 4.2 days of SOC intervention, taking 15.4 min daily with no reported adverse event (coughing, wet voice, or decreased oxygen saturation) during and immediately after intervention. Participants who received the intervention were significantly more likely than controls to resume total oral intake after extubation (aHR 1.77, 95% CI 1.08-2.91). Stratified by age group, older participants (? 65 years) in the SOC group were 2.47-fold more likely than their younger counterparts to resume total oral intake (aHR 2.47, 95% CI 1.31-4.67). The SOC group also had significantly higher salivary flows 14 days following extubation (β = 0.67, 95% CI 0.29-1.06). Conclusions: The nurse-administered SOC is safe and effective, with greater odds of patients' resuming total oral intake and increased salivary flows 14 days following endotracheal extubation. Age matters with SOC; it more effectively helped participants ? 65 years old resume total oral intake postextubation. Trial registration: NCT02334774, registered on January 08, 2015 ? 2019 The Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85074741722&doi=10.1186%2fs13054-019-2623-2&partnerID=40&md5=74435f4129aee4db50ae5b76d283a468 https://scholars.lib.ntu.edu.tw/handle/123456789/483512 |
ISSN: | 1364-8535 | DOI: | 10.1186/s13054-019-2623-2 | SDG/關鍵字: | adverse event; aged; Article; controlled study; coughing; endotracheal intubation; extubation; female; food intake; hospital care; human; intensive care unit; major clinical study; male; mouth hygiene; oxygen saturation; patient education; priority journal; salivation; swallowing; swallowing and oral care intervention; tooth brushing; adverse event; critical illness; drug effect; extubation; middle aged; mouth; nursing; pathophysiology; procedures; very elderly; Aged; Aged, 80 and over; Airway Extubation; Critical Illness; Deglutition; Female; Humans; Male; Middle Aged; Mouth |
顯示於: | 醫學系 |
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