Fiberoptic endoscopic documentation of the high incidence of aspiration following extubation in critically ill trauma patients

Steven B. Leder, Stephen M. Cohn, Beth A. Moller

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

The purpose of this study was to investigate the incidence of aspiration following extubation in critically ill trauma patients. This prospective pilot study included 20 consecutive trauma patients who required orotracheal intubation for at least 48 hours. All subjects underwent a bedside transnasal fiberoptic endoscopic evaluation of swallowing at 24 ± 2 hr after extubation to determine objectively aspiration status. Aspiration was defined as the entry of a blue dyed material into the airway below the level of the true vocal folds, with silent aspiration occurring in the absence of any external behavioral signs such as coughing or choking. Aspiration was identified in 9 of 20 (45%) subjects and 4 of these 9 (44%) were silent aspirators. Therefore, silent aspiration occurred in 20% of the study population. Eight of the 9 (89%) aspirating subjects resumed an oral diet from 2-10 days (mean, 5 days) following extubation. All subjects had no evidence of pulmonary complications. It was concluded that trauma patients after orotracheal intubation and prolonged mechanical ventilation have an increased risk of aspiration. An objective assessment of dysphagia to identify aspiration may reduce the likelihood of pulmonary complications after extubation.

Original languageEnglish (US)
Pages (from-to)208-212
Number of pages5
JournalDysphagia
Volume13
Issue number4
DOIs
StatePublished - 1998
Externally publishedYes

Fingerprint

Critical Illness
Documentation
Intubation
Incidence
Wounds and Injuries
Lung
Vocal Cords
Airway Obstruction
Deglutition
Deglutition Disorders
Artificial Respiration
Prospective Studies
Diet
Population

Keywords

  • Aspiration
  • Deglutition
  • Deglutition disorders
  • Extubation
  • Fiberoptic endoscope
  • Orotracheal intubation
  • Silent aspiration
  • Trauma

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Gastroenterology

Cite this

Fiberoptic endoscopic documentation of the high incidence of aspiration following extubation in critically ill trauma patients. / Leder, Steven B.; Cohn, Stephen M.; Moller, Beth A.

In: Dysphagia, Vol. 13, No. 4, 1998, p. 208-212.

Research output: Contribution to journalArticle

Leder, Steven B. ; Cohn, Stephen M. ; Moller, Beth A. / Fiberoptic endoscopic documentation of the high incidence of aspiration following extubation in critically ill trauma patients. In: Dysphagia. 1998 ; Vol. 13, No. 4. pp. 208-212.
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