https://scholars.lib.ntu.edu.tw/handle/123456789/483543
Title: | Swallowing dysfunction following endotracheal intubation Age matters | Authors: | Tsai M.-H. SHIH-CHI KU TYNG-GUEY WANG Hsiao T.-Y. JANG-JAER LEE DING-CHENG CHAN Huang G.-H. CHERYL CHIA-HUI CHEN |
Issue Date: | 2016 | Publisher: | Lippincott Williams and Wilkins | Journal Volume: | 95 | Journal Issue: | 24 | Start page/Pages: | e3871 | Source: | Medicine (United States) | Abstract: | To evaluate postextubation swallowing dysfunction (PSD) 21 days after endotracheal extubation and to examine whether PSD is time-limited and whether age matters. For this prospective cohort study, we evaluated 151 adult critical care patients (?20 years) who were intubated for at least 48hours and had no pre-existing neuromuscular disease or swallowing dysfunction. Participants were assessed for time (days) to pass bedside swallow evaluations (swallow 50mL of water without difficulty) and to resume total oral intake. Outcomes were compared between younger (20-64 years) and older participants (?65 years). PSD, defined as inability to swallow 50mL of water within 48hours after extubation, affected 92 participants (61.7% of our sample). At 21 days postextubation, 17 participants (15.5%) still failed to resume total oral intake and were feeding-tube dependent. We found that older participants had higher PSD rates at 7, 14, and 21 days postextubation, and took significantly longer to pass the bedside swallow evaluations (5.0 vs 3.0 days; P=0.006) and to resume total oral intake (5.0 vs 3.0 days; P=0.003) than their younger counterparts. Older participants also had significantly higher rates of subsequent feeding-tube dependence than younger patients (24.1 vs 5.8%; P=0.008). Excluding patients with pre-existing neuromuscular dysfunction, PSD is common and prolonged. Age matters in the time needed to recover. Swallowing and oral intake should be monitored and interventions made, if needed, in the first 7 to 14 days postextubation, particularly for older patients. ? 2016 Wolters Kluwer Health, Inc. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84976430953&doi=10.1097%2fMD.0000000000003871&partnerID=40&md5=05259bbd21a95d1767576fb5d80839de https://scholars.lib.ntu.edu.tw/handle/123456789/483543 |
ISSN: | 0025-7974 | DOI: | 10.1097/MD.0000000000003871 | SDG/Keyword: | adult; aged; Article; Charlson Comorbidity Index; cohort analysis; controlled study; dysphagia; endotracheal intubation; feeding apparatus; female; follow up; human; intensive care; major clinical study; male; outcome assessment; postextubation swallowing dysfunction; priority journal; prospective study; adverse effects; age; age distribution; Deglutition Disorders; endotracheal intubation; incidence; middle aged; pathophysiology; physiology; procedures; risk factor; swallowing; Taiwan; time factor; Age Distribution; Age Factors; Aged; Critical Care; Deglutition; Deglutition Disorders; Female; Follow-Up Studies; Humans; Incidence; Intubation, Intratracheal; Male; Middle Aged; Prospective Studies; Risk Factors; Taiwan; Time Factors [SDGs]SDG3 |
Appears in Collections: | 醫學系 |
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