Management and treatment of dysphagia in intubated patients in the Greek-Cypriot ICU's.
Journal
Intensive Care Medicine Experimental
Date Issued
May 15, 2024
Author(s)
DOI
doi.org/10.1186/s40635-023-00546-y
Abstract
Introduction: Post-extubation dysphagia (PED) can lead to serious
health problems in vulnerable critically ill patients, yet routine bedside
screening may be lacking in many Intensive Care Units (ICUs), possibly
due to limited awareness for this condition.
Objectives: The present study aimed to establish baseline data on
the current approaches, the status of perceived best practices to PED
management and treatment, as well as to assess awareness of PED and
its consequences. The questionnaire was completed by a designated
clinician, after consultation with the ICU team.
Methods: A nationwide cross-sectional, online survey was conducted
of all adult ICUs (n = 14; response rate 100%) in the Republic of Cyprus.
Results: None of the included ICUs had a dedicated speech and
language pathologist/ therapist (SLP/SLT). More than 85% of ICUs
reported that there was no standard protocol indicating which
patients should be screened for PED. Cough reflex testing and water
swallow test were the most commonly reported assessment methods
used to confirm the presence of PED. In the majority of ICUs (64.3%),
nurses and intensivists were responsible to assess PED as well as SLP/
SLTs. Muscle strengthening exercises without swallowing and swallowing
exercises were mostly used to treat dysphagia. Of the ICUs, 71.4%
reported the need for standard protocols for PED screening. Overall,
28.6% of the ICUs agreed that PED was common in their unit.
Conclusions: We identified gaps in Greek Cypriot ICUs awareness and
practice regarding PED management, treatment, and consequences.
Comprehensive unit-based dysphagia education programs must
be urgently implemented. Interdisciplinary and collaborative work
between nurses, intensivists and SLPs is needed to improve the quality
of care provided.
health problems in vulnerable critically ill patients, yet routine bedside
screening may be lacking in many Intensive Care Units (ICUs), possibly
due to limited awareness for this condition.
Objectives: The present study aimed to establish baseline data on
the current approaches, the status of perceived best practices to PED
management and treatment, as well as to assess awareness of PED and
its consequences. The questionnaire was completed by a designated
clinician, after consultation with the ICU team.
Methods: A nationwide cross-sectional, online survey was conducted
of all adult ICUs (n = 14; response rate 100%) in the Republic of Cyprus.
Results: None of the included ICUs had a dedicated speech and
language pathologist/ therapist (SLP/SLT). More than 85% of ICUs
reported that there was no standard protocol indicating which
patients should be screened for PED. Cough reflex testing and water
swallow test were the most commonly reported assessment methods
used to confirm the presence of PED. In the majority of ICUs (64.3%),
nurses and intensivists were responsible to assess PED as well as SLP/
SLTs. Muscle strengthening exercises without swallowing and swallowing
exercises were mostly used to treat dysphagia. Of the ICUs, 71.4%
reported the need for standard protocols for PED screening. Overall,
28.6% of the ICUs agreed that PED was common in their unit.
Conclusions: We identified gaps in Greek Cypriot ICUs awareness and
practice regarding PED management, treatment, and consequences.
Comprehensive unit-based dysphagia education programs must
be urgently implemented. Interdisciplinary and collaborative work
between nurses, intensivists and SLPs is needed to improve the quality
of care provided.
Subjects