Association of Post-extubation Dysphagia With Tongue Weakness and Somatosensory Disturbance in Non-neurologic Critically Ill Patients.
10.5535/arm.2017.41.6.961
- Author:
Hee Seon PARK
1
;
Jung Hoi KOO
;
Sun Hong SONG
Author Information
1. Department of Rehabilitation Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea. mdjhkoo@gnah.co.kr
- Publication Type:Original Article
- Keywords:
Aspiration;
Critical illness;
Deglutition disorders;
Fluoroscopy;
Intratracheal intubation
- MeSH:
Adult;
Critical Illness*;
Cross-Sectional Studies;
Deglutition;
Deglutition Disorders*;
Discrimination (Psychology);
Fluoroscopy;
Humans;
Incidence;
Intensive Care Units;
Intubation;
Intubation, Intratracheal;
Length of Stay;
Lip;
Medical Records;
Pneumonia;
Prospective Studies;
Sensation;
Tongue*
- From:Annals of Rehabilitation Medicine
2017;41(6):961-968
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To prospectively assess the association between impoverished sensorimotor integration of the tongue and lips and post-extubation dysphagia (PED). METHODS: This cross-sectional study included non-neurologic critically ill adult patients who required endotracheal intubation and underwent videofluoroscopic swallowing study (VFSS) between October and December 2016. Participants underwent evaluation for tongue and lip performance, and oral somatosensory function. Demographic and clinical data were retrieved from medical records. RESULTS: Nineteen patients without a definite cause of dysphagia were divided into the non-dysphagia (n=6) and the PED (n=13) groups based on VFSS findings. Patients with PED exhibited greater mean duration of intubation (11.85±3.72 days) and length of stay in the intensive care unit (LOS-ICU; 13.69±3.40 days) than those without PED (6.83±5.12 days and 9.50±5.96 days; p=0.02 and p=0.04, respectively). The PED group exhibited greater incidence of pneumonia, higher videofluoroscopy swallow study dysphagia scale score, higher oral transit time, and lower tongue power and endurance and lip strength than the non-dysphagia groups. The differences in two-point discrimination and sensations of light touch and taste among the two groups were insignificant. Patients intubated for more than 7 days exhibited lower maximal tongue power and tongue endurance than those intubated for less than a week. CONCLUSION: Duration of endotracheal intubation, LOS-ICU, and oromotor degradation were associated with PED development. Oromotor degradation was associated with the severity of dysphagia. Bedside oral performance evaluation might help identify patients who might experience post-extubation swallowing difficulty.
