The accuracy of the bedside swallowing evaluation for detecting aspiration in survivors of acute respiratory failure.

Background: Dysphagia with subsequent aspiration occurs in up to 60% of acute respiratory failure (ARF) survivors. Accurate bedside tests for aspiration can reduce aspiration-related complications while minimizing delay of oral nutrition. In a cohort of ARF survivors, we determined the accuracy of the bedside swallowing evaluation (BSE) and its components for detecting aspiration.

ICU-acquired swallowing disorders.

Objectives: Patients hospitalized in the ICU can frequently develop swallowing disorders, resulting in an inability to effectively transfer food, liquids, and pills from their mouth to stomach. The complications of these disorders can be devastating, including aspiration, reintubation, pneumonia, and a prolonged hospital length of stay. As a result, critical care practitioners should understand the optimal diagnostic strategies, proposed mechanisms, and downstream complications of these ICU-acquired swallowing disorders.

Post-extubation dysphagia is associated with longer hospitalization in survivors of critical illness with neurologic impairment.

Introduction: Critically ill patients can develop acute respiratory failure requiring endotracheal intubation. Swallowing dysfunction after liberation from mechanical ventilation, also known as post-extubation dysphagia, is common and deleterious among patients without neurologic disease. However, the risk factors associated with the development of post-extubation dysphagia and its effect on hospital lengthofstay in critically ill patients with neurologic disorders remains relatively unexplored.

Diagnosis and treatment of post-extubation dysphagia: results from a national survey.

Purpose: This study sought to determine the utilization of speech-language pathologist (SLPs) for the diagnosis and treatment of post-extubation dysphagia in survivors of mechanical ventilation.

Methods: We designed, validated, and mailed a survey to 1,966 inpatient SLPs who routinely evaluate patients for post-extubation dysphagia.

Results: Most SLP diagnostic evaluations (60%; 95% CI, 59%-62%) were performed using clinical techniques with uncertain accuracy.

Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness.

Introduction: Dysphagia is common among survivors of critical illness who required mechanical ventilation during treatment. The risk factors associated with the development of postextubation dysphagia, and the effects of dysphagia on patient outcomes, have been relatively unexplored.

Methods: We conducted a retrospective, observational cohort study from 2008 to 2010 of all patients over 17 years of age admitted to a university hospital ICU who required mechanical ventilation and subsequently received a bedside swallow evaluation (BSE) by a speech pathologist.