Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours?

Authors

Steven B. Leder, 1 Department of Surgery, Section of Otolaryngology, Yale School of Medicine, New Haven, CT, USA.
Heather L. Warner, 2 Southern Connecticut State University, New Haven, CT, USA.
Debra M. Suiter, 3 University of Kentucky, Lexington, KY, USA.
Nwanmegha O. Young, 1 Department of Surgery, Section of Otolaryngology, Yale School of Medicine, New Haven, CT, USA.
Bishwajit Bhattacharya, 4 Department of Surgery, Section of Trauma, Surgical Critical Care, and Surgical Emergencies, Yale School of Medicine, New Haven, CT, USA.Follow
Jonathan M. Siner, 5 Department of Internal Medicine, Section of Pulmonary, Critical Care, & Sleep Medicine, Yale School of Medicine, New Haven, CT, USA.
Kimberly A. Davis, 4 Department of Surgery, Section of Trauma, Surgical Critical Care, and Surgical Emergencies, Yale School of Medicine, New Haven, CT, USA.Follow
Linda L. Maerz, 4 Department of Surgery, Section of Trauma, Surgical Critical Care, and Surgical Emergencies, Yale School of Medicine, New Haven, CT, USA.Follow
Stanley H. Rosenbaum, 6 Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA.Follow
Peter S. Marshall, 5 Department of Internal Medicine, Section of Pulmonary, Critical Care, & Sleep Medicine, Yale School of Medicine, New Haven, CT, USA.
Margaret A. Pisani, 7 Department of Pulmonary Critical Care & Sleep Medicine, Yale School of Medicine, New Haven, CT, USA.
Mark D. Siegel, 5 Department of Internal Medicine, Section of Pulmonary, Critical Care, & Sleep Medicine, Yale School of Medicine, New Haven, CT, USA.
Joseph J. Brennan, 8 Department of Cardiology, Yale School of Medicine, New Haven, CT, USA.
Kevin M. Schuster, 4 Department of Surgery, Section of Trauma, Surgical Critical Care, and Surgical Emergencies, Yale School of Medicine, New Haven, CT, USA.Follow

Document Type

Article

Publication Title

The Annals of otology, rhinology, and laryngology

Abstract

BACKGROUND: Post-extubation dysphagia is associated with an increased incidence of nosocomial pneumonias, longer hospitalizations, and higher re-intubation rates. The purpose of this study was to determine if it is necessary to delay swallow evaluation for 24 hours post-extubation. METHODS: A prospective investigation of swallowing was conducted at 1, 4, and 24 hours post-extubation to determine if it is necessary to delay swallow evaluation following intubation. Participants were 202 adults from 5 different intensive care units (ICU). RESULTS: A total of 166 of 202 (82.2%) passed the Yale Swallow Protocol at 1 hour post-extubation, with an additional 11 (177/202; 87.6%) at 4 hours, and 8 more (185/202; 91.6%) at 24 hours. Only intubation duration ≥4 days was significantly associated with nonfunctional swallowing. CONCLUSIONS: We found it is not necessary to delay assessment of swallowing in individuals who are post-extubation. Specifically, the majority of patients in our study (82.2%) passed a swallow screening at 1 hour post-extubation.

First Page

619

Last Page

624

DOI

10.1177/0003489419836115

Publication Date

7-1-2019

Recommended Citation

Leder, Steven B.; Warner, Heather L.; Suiter, Debra M.; Young, Nwanmegha O.; Bhattacharya, Bishwajit; Siner, Jonathan M.; Davis, Kimberly A.; Maerz, Linda L.; Rosenbaum, Stanley H.; Marshall, Peter S.; Pisani, Margaret A.; Siegel, Mark D.; Brennan, Joseph J.; and Schuster, Kevin M., "Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours?" (2019). Surgery. 51.
https://scholar.bridgeporthospital.org/surgery/51

Identifier

30841709 (pubmed); 10.1177/0003489419836115 (doi)