학술논문
Prevalence of Post-extubation Airway Penetration and Aspiration among Critically Ill Patients Assessed by an Eight-point Penetration-Aspiration Scale Using Flexible Endoscopy: A Cross-sectional Study.
Document Type
Academic Journal
Author
Vijayan D; Department of Critical Care Medicine, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India.; Kumar VS; Department of Critical Care Medicine, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India.; Harikrishnanan; Department of Critical Care Medicine, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India.; Menon J; Deparment of Laryngology, Kerala Institute of Medical sciences, Trivandrum, Kerala, India.; Ragitha; Deparment of Laryngology, Kerala Institute of Medical sciences, Trivandrum, Kerala, India.; Jacob M; Deparment of Laryngology, Kerala Institute of Medical sciences, Trivandrum, Kerala, India.; Kunhu S; Department of Critical Care Medicine, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India.
Source
Publisher: Jaypee Brothers Medical Publishers Pvt. Ltd. on behalf of Indian Society of Critical Care Medicine Country of Publication: India NLM ID: 101208863 Publication Model: Print Cited Medium: Print ISSN: 0972-5229 (Print) Linking ISSN: 09725229 NLM ISO Abbreviation: Indian J Crit Care Med Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
0972-5229
Abstract
Introduction: Prolonged endotracheal intubation was found to be a risk factor for pulmonary aspiration following the extubation. In this study, we have tried to analyze the prevalence of airway penetration and aspiration among mechanically ventilated patient who received mechanical ventilation for a period of 48 hours or more.
Materials and Methods: This cross-sectional study was done among non-neurologic critically ill patients who had an endotracheal tube for more than 48 hours and who got extubated subsequently. Such patients were taken for a fiberoptic endoscopic swallow study after the initial assessment by a speech pathologist. Airway penetration and aspiration was assessed by an eight-point penetration-aspiration scale after giving a test feed.
Results: Data of 99 patients were analyzed. Mean duration of intubation was 5.9 days. 1% of the patients had aspiration and 20% of the patients had varying degrees of penetration. Duration of endotracheal intubation, age, sex, comorbidities, admission diagnosis, and size of the endotracheal tube were found to have no association with penetration and aspiration.
Conclusion: Prevalence of post-extubation aspiration was low among non-neurologic critically ill patients on short-term ventilation. Duration of endotracheal intubation, age, sex, comorbidities, and endotracheal tube size were not found to be significantly associated with the development of airway penetration.
Key Message: Contrary to previous studies, this study has shown that among non-neurologic critically ill patients who had an endotracheal tube for a shorter period before extubation, the prevalence of airway penetration and aspiration was low when assessed by an eight-point penetration-aspiration scale using flexible fiberoptic endoscopy. Hence, in such a cohort of patients, a routine swallowing evaluation by flexible endoscopy is not recommended.
How to Cite This Article: Vijayan D, Suresh Kumar VK, Harikrishnanan, Menon J, Ragitha, Jacob M, et al . Prevalence of Post-extubation Airway Penetration and Aspiration among Critically Ill Patients Assessed by an Eight-point Penetration-Aspiration Scale Using Flexible Endoscopy: A Cross-sectional Study. Indian J Crit Care Med 2023;27(9):651-654.
Competing Interests: Source of support: Nil Conflict of interest: None
(Copyright © 2023; The Author(s).)
Materials and Methods: This cross-sectional study was done among non-neurologic critically ill patients who had an endotracheal tube for more than 48 hours and who got extubated subsequently. Such patients were taken for a fiberoptic endoscopic swallow study after the initial assessment by a speech pathologist. Airway penetration and aspiration was assessed by an eight-point penetration-aspiration scale after giving a test feed.
Results: Data of 99 patients were analyzed. Mean duration of intubation was 5.9 days. 1% of the patients had aspiration and 20% of the patients had varying degrees of penetration. Duration of endotracheal intubation, age, sex, comorbidities, admission diagnosis, and size of the endotracheal tube were found to have no association with penetration and aspiration.
Conclusion: Prevalence of post-extubation aspiration was low among non-neurologic critically ill patients on short-term ventilation. Duration of endotracheal intubation, age, sex, comorbidities, and endotracheal tube size were not found to be significantly associated with the development of airway penetration.
Key Message: Contrary to previous studies, this study has shown that among non-neurologic critically ill patients who had an endotracheal tube for a shorter period before extubation, the prevalence of airway penetration and aspiration was low when assessed by an eight-point penetration-aspiration scale using flexible fiberoptic endoscopy. Hence, in such a cohort of patients, a routine swallowing evaluation by flexible endoscopy is not recommended.
How to Cite This Article: Vijayan D, Suresh Kumar VK, Harikrishnanan, Menon J, Ragitha, Jacob M, et al . Prevalence of Post-extubation Airway Penetration and Aspiration among Critically Ill Patients Assessed by an Eight-point Penetration-Aspiration Scale Using Flexible Endoscopy: A Cross-sectional Study. Indian J Crit Care Med 2023;27(9):651-654.
Competing Interests: Source of support: Nil Conflict of interest: None
(Copyright © 2023; The Author(s).)