Dysphagia following cardiovascular surgery: a clinical overview.

The objective of this clinical paper is to enhance nurses' understanding of normal swallowing physiology and post-operative swallowing impairments (dysphagia) in patients following cardiovascular surgery. Ultimately, the goals of dysphagia assessment and management are to prevent pulmonary complications secondary to aspiration and to ensure safe and adequate nutritional intake and hydration. Risk factors for dysphagia include stroke, compromised respiratory status, endotracheal intubation and/or tracheostomy tubes, and a dependency for feeding and oral care. Other patient characteristics associated with the presence of dysphagia following cardiovascular surgery include advanced age, preoperative congestive heart failure, diabetes, intraoperative use of transesophageal echocardiography, and prolonged intubation. Clinical and instrumental dysphagia assessment methods are reviewed. A case report is used to illustrate the benefit of nursing involvement in the care of a patient with dysphagia following cardiovascular surgery.