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Clinical Rehabilitation, Vol. 21, No. 1,
41-46 (2007)
DOI: 10.1177/0269215506071286
Pre-emptive swallowing stimulation in long-term intubated patients
Chang Ho Hwang
Department of Physical Medicine and Rehabilitation Medicine, Ulsan University Hospital, Ulsan, Seoul, Korea
Kyoung Hyo Choi
Department of Physical Medicine and Rehabilitation Medicine, Seoul, Korea
Yoon Suk Ko
Chae Man Leem
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Objective: To evaluate the effect of pre-emptive swallowing stimulation on the recovery of swallowing function in long-term intubated patients.
Design and subjects: Patients in the intensive care unit intubated for at least 48 hours due to respiratory distress from March to August 2004 were randomly divided into two groups. Fifteen patients of mean age 55.39±17.9 years were stimulated (experimental group) and 18 patients of mean age 61.39±13.5 years were not stimulated (control group). The duration of intubation was 15.59±6.7 days in the experimental group and 15.79±6.5 days in the control group. Duration of stimulation in the experimental group was 7.39±3.6 days. After extubation, we compared the severity of dysphagia via video-fluoroscopic swallow study.
Results: There were no statistically significant differences in the percentage of aspiration and the swallowed volume between the two groups. However, oral transit time in the experimental group (0.379±0.07 seconds) was significantly shorter than that of the control group (0.839±0.10 seconds), and the oropharyngeal swallowing efficiency of the experimental group (73.39±17.4%/s) was significantly higher than that of the control group (50.19±13.0%/s).
Conclusion: Pre-emptive swallowing stimulation during intubation assists in the recovery of swallowing function in long-term intubated patients.
References
- Ajemian MS, Nirmul GB, Anderson MT, Zirlen DM, Kwasnik EM. Routine fiberoptic endoscopic evaluation of swallowing following prolonged intubation: implications for management . Arch Surg 2001; 136: 434437 .[Abstract/Free Full Text]
- Barquist E, Brown M, Cohn S, Lundy D, Jackowski J. Postextubation fiberoptic endoscopic evaluation of swallowing after prolonged endotracheal intubation: a randomized, prospective trial . Crit Care Med 2001; 29: 17101713 .[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Leder SB, Cohn SM, Moller BA. Fiberoptic endoscopic documentation of the high incidence of aspiration following extubation in critically ill trauma patients . Dysphagia 1998; 13: 208212 .[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Kastanos N, Estopa Miro R, Marin Perez A, Xaubet Mir A, Agusti-Vidal A. Laryngotracheal injury due to endotracheal intubation: incidence, evolution, and predisposing factors. A prospective long-term study . Crit Care Med 1983; 11: 362367 .[ISI][Medline]
[Order article via Infotrieve]
- de Larminat V, Montravers P, Dureuil B, Desmonts JM. Alteration in swallowing reflex after extubation in intensive care patients . Crit Care Med 1995; 23: 486490 .[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Stauffer JL, Olson DE, Petty TL. Complications and consequences of endotracheal intubation and tracheostomy . Am J Med 1981; 70: 6575 .[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Colice GL, Stukel TA, Dain B. Laryngeal complications of prolonged intubation . Chest 1989; 96: 877884 .
- Whited RE. A prospective study of laryngotracheal sequelae in long-term intubation . Laryngoscope 1984; 94: 367376 .[ISI][Medline]
[Order article via Infotrieve]
- Han TR, Back NJ, Park JW. The functional dysphagia scale using videofluoroscopic swallowing study in stroke patients . J Korean Acad Rehabil Med 1999; 23: 11181126 .
- Logemann JA, Kahrilas P, Kobara M, Vakil NB. The benefit of head rotation on pharyngoesophageal dysphagia . Arch Phys Med Rehabil 1989; 70: 767771 .[ISI][Medline]
[Order article via Infotrieve]
- Tolep K, Getch CL, Criner GJ. Swallowing dysfunction in patients receiving prolonged mechanical ventilation . Chest 1996; 109: 167172 .
- Leder SB, Ross DA. Investigation of the causal relationship between tracheostomy and aspiration in the acute care setting . Laryngoscope 2000; 110: 641644 .[CrossRef][ISI][Medline]
[Order article via Infotrieve]

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