OBJECTIVES: To assess the swallowing reflex after prolonged endotracheal intubation and to assess the influence of age and duration of intubation on this reflex. DESIGN: Prospective, observational, clinical study. SETTING: The intensive care unit of a university teaching hospital. PATIENTS: The swallowing reflex was studied after extubation in 34 patients and compared with the deglutition in 30 nonintubated patients with a nasogastric tube and 15 nonintubated patients without a nasogastric tube. INTERVENTIONS: Four volumes of normal saline (0.25, 0.50, 0.75, and 1 mL) were injected at the epipharynx level. Swallowing efficiency was assessed by the latency between instillation and the first swallow, as identified on a submental electromyogram. The tests were performed immediately (day 0), and at 1 (day 1), 2 (day 2), and 7 (day 7) days after extubation in the intubated group. Nonintubated patients were tested once. MEASUREMENTS AND MAIN RESULTS: On day 0, the latency was increased for each bolus in the extubated group when compared with the control groups. Significant shortening of latency after 0.50, 0.75, and 1 mL injections of normal saline occurred on days 1 and 2 when compared with day 0, whereas no change was observed after 0.25 mL of normal saline was injected. On day 7, a significant improvement was observed, regardless of the volume injected. There was no correlation between swallowing latency and either the age of the patients or the duration of endotracheal intubation. CONCLUSIONS: These data indicate that prolonged endotracheal intubation impairs the swallowing reflex, with improvement within 1 wk. This phenomenon could contribute to microinhalations and aspiration pneumonia after extubation.
OBJECTIVES: To assess the swallowing reflex after prolonged endotracheal intubation and to assess the influence of age and duration of intubation on this reflex. DESIGN: Prospective, observational, clinical study. SETTING: The intensive care unit of a university teaching hospital. PATIENTS: The swallowing reflex was studied after extubation in 34 patients and compared with the deglutition in 30 nonintubated patients with a nasogastric tube and 15 nonintubated patients without a nasogastric tube. INTERVENTIONS: Four volumes of normal saline (0.25, 0.50, 0.75, and 1 mL) were injected at the epipharynx level. Swallowing efficiency was assessed by the latency between instillation and the first swallow, as identified on a submental electromyogram. The tests were performed immediately (day 0), and at 1 (day 1), 2 (day 2), and 7 (day 7) days after extubation in the intubated group. Nonintubated patients were tested once. MEASUREMENTS AND MAIN RESULTS: On day 0, the latency was increased for each bolus in the extubated group when compared with the control groups. Significant shortening of latency after 0.50, 0.75, and 1 mL injections of normal saline occurred on days 1 and 2 when compared with day 0, whereas no change was observed after 0.25 mL of normal saline was injected. On day 7, a significant improvement was observed, regardless of the volume injected. There was no correlation between swallowing latency and either the age of the patients or the duration of endotracheal intubation. CONCLUSIONS: These data indicate that prolonged endotracheal intubation impairs the swallowing reflex, with improvement within 1 wk. This phenomenon could contribute to microinhalations and aspiration pneumonia after extubation.
Authors: J D Rollnik; J Adolphsen; J Bauer; M Bertram; J Brocke; C Dohmen; E Donauer; M Hartwich; M D Heidler; V Huge; S Klarmann; S Lorenzl; M Lück; M Mertl-Rötzer; T Mokrusch; D A Nowak; T Platz; L Riechmann; F Schlachetzki; A von Helden; C W Wallesch; D Zergiebel; M Pohl Journal: Nervenarzt Date: 2017-06 Impact factor: 1.214
Authors: Martin B Brodsky; Jonathan E Gellar; Victor D Dinglas; Elizabeth Colantuoni; Pedro A Mendez-Tellez; Carl Shanholtz; Jeffrey B Palmer; Dale M Needham Journal: J Crit Care Date: 2014-02-27 Impact factor: 3.425
Authors: Martin B Brodsky; Marlís González-Fernández; Pedro A Mendez-Tellez; Carl Shanholtz; Jeffrey B Palmer; Dale M Needham Journal: Ann Am Thorac Soc Date: 2014-12
Authors: R S Ambika; Badari Datta; B V Manjula; Unmesh V Warawantkar; Anita Mariet Thomas Journal: Indian J Otolaryngol Head Neck Surg Date: 2018-03-05