Martha MVA, Castro SA, Sumano GA, Martínez DBA, Aguirre SJS

Language: Spanish
References: 16
Page: 638-645
PDF size: 260.90 Kb.

ABSTRACT

Introduction: dysphagia is defined as an alteration of the process of swallowing or eating that can occur in any of its phases (oral, pharyngeal or esophageal), could be present as retardation of aliment bolus (solid or liquid) from the oral cavity to the stomach, with increasing risks of complications such as need for reintubation, aspiration pneumonia and/or acute respiratory distress syndrome. The purpose of this investigation is the creation of a predictive score that could stratify the risk of presenting dysphagia of recently extubated patients during their stay in the intensive care unit. Material and methods: we conducted an observational, retrospective, multivariate study. We analyzed data from patients admitted between 2016 and 2023 with more than 24 hours of mechanical ventilation with endotracheal tube and subsequently received a bedside swallowing evaluation function thru fiberoptic endoscopic visualization (FEES). The factors analyzed included age, sex, admission APACHE II, SAPS II and NUTRIC scores, the presence of comorbidities, intensive care unit (ICU) length of stay, intubation length, ARDS as main cause of intubation, use of steroids and infusion of neuromuscular blockers and need of reintubation. Results: after excluding patients with previous dysphagia, our study sample size was 118 patients. Using the chi square test we determined the odds ratio for each factor. We found that the odds ratio of prognostic factors such as age over 65 years, previous history of cancer, ARDS as main cause of intubation, use of steroids and neuromuscular blockers, intubation length and need of reintubation were significant. Conclusions: the use of this score could be applied to predict the risk of postextubation oropharyngeal dysphagia, with the goal of implementing means that could prevent complications linked to swallowing disorders.

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