JMIR Publications

ABSTRACT

Background:

Post critical illness dysphagia occurs in about 10% to 62% of patients in the intensive care unit (ICU). Studies focusing on risk factors for dysphagia following endotracheal intubation are scarce and provide conflicting results. More research is required to determine the true prevalence of dysphagia, possible mechanisms and risk factors.

Objective:

The aims of the study are to determine: 1) risk factors associated with post critical illness dysphagia, 2) the prevalence of post critical illness dysphagia, 3) outcomes of patients with post critical illness dysphagia, 4) diagnostic accuracy of water sip test compared to fiberoptic endoscopic evaluation of swallowing (FEES).

Methods:

We plan to undertake a single center study of post critical illness dysphagia. Our inclusion criteria are: 1) adults (18 years of age and older), 2) undergone invasive mechanical ventilation for > 24 hours, 3) have been extubated for >24 hours, 4) able to participate in a FEES, and 4) hemodynamically stable. Daily, the research coordinator (RC) will screen all patients in the ICU for enrolment in the study. The RC will collect daily data on the use of advance life support, need for mechanical ventilation and outcomes (mortality, duration of mechanical ventilation, ICU length of stay, hospital length of stay). Enrolled patients will undergo a water sip test in the ICU and FEES performed by a certified speech-language pathologist (SLP). Patients will then be followed during hospital stay censored at 30 days as two cohorts: 1) patients that have dysphagia (i.e. abnormal FEES), and 2) patients who have normal FEES.

Results:

The results of this observational study will determine the prevalence of post critical illness dysphagia and risk factors associated with development of dysphagia in the ICU, which will provide foundation for future work on the prevention and treatment of post critical illness dysphagia

Conclusions:

The study findings will promote early intervention for post-critical illness dysphagia patients, improve multidisciplinary care, and inform policymakers for better resource allocation.