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206595

Factors Contributing to Post Extubation Dysphagia in Critically Ill Patients

Article

Last updated: 23 Jan 2023

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Abstract

Critically care nurses play an important role to investigate and early detect suspected
complications from the intubation process such as post-extubation dysphagia. Post-extubation
dysphagia has negative consequences which can be classified into physiological such as malnutrition
and/or dehydration, chocking, chest infection and aspiration pneumonia, in addition to psychological,
and economic consequences as post-extubation dysphagia could increase the consumption of supplies,
human resources, workload and the overall cost of care. There are many factors that contribute to the
development of post-extubation dysphagia, which include: physiological changes related factors; age,
pathological related factors; initial diagnosis and comorbidies and therapeutic related factors;
presence of tracheal and gastric tube, in addition to some medications that may lead to dysphagia.
Objective: Identify factors contributing to post-extubation dysphagia in critically ill patients. Setting:
This study was conducted in the General Medical ICUs namely; Casualty unit (unit I), (unit III) and
Continuous Renal Replacement Therapy at the Alexandria Main University Hospital (AMUH). In
addition to Almoassat General ICU. Subjects: A convenience sample of 50 adult intubated critically
ill patients. Tools: Two tools were used for data collection: “Factors Contributing to Post-extubation
Dysphagia Assessment" and “Gugging Swallowing Screen". Results: The differences between the
studied patients according to the occurrence of post-extubation dysphagia at first 6hrs compared to
after 12hrs and after 24 hrs was statistically significant (p=<0.001). The duration of mechanical
ventilation was the only significant risk factor to post-extubation dysphagia after 24hrs according to
the binary logistic regression analysis. Conclusion: All the studied patients developed post-extubation
dysphagia by the first 6 hrs of extubation. The severity of post-extubation dysphagia varied between
mild, moderate and severe. Critically ill patients were highly susceptible for exposure of multiple
iatrogenic factors which can contribute to post-extubation dysphagia during ICU stay. The only
significant risk factor to post-extubation dysphagia after 24hrs was the duration of mechanical
ventilation. Recommendations: Critical care nurses should be continuously monitor the intubated
critically ill patients who are risky to develop post extubation dysphagia, and continuous in-serve
training programs for CCNs in the ICUs.

DOI

10.21608/asalexu.2019.206595

Keywords

Critical illness, Dysphagia, nursing care, Post-extubation dysphagia

Authors

First Name

Elham

Last Name

Abdalla

MiddleName

Ashraf

Affiliation

Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

Email

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City

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Orcid

-

First Name

Nadia T

Last Name

Mohamed

MiddleName

Taha

Affiliation

Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

Email

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City

-

Orcid

-

First Name

Fatma

Last Name

El-Fattah

MiddleName

Refaat

Affiliation

Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

Email

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City

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Orcid

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First Name

Hany

Last Name

Assaad

MiddleName

Samir

Affiliation

Critical Care Medicine, Faculty of Medicine, Alexandria University

Email

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City

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Orcid

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Volume

21

Article Issue

2

Related Issue

29096

Issue Date

2019-12-01

Receive Date

2021-11-27

Publish Date

2019-12-01

Page Start

33

Page End

48

Print ISSN

1687-3858

Link

https://asalexu.journals.ekb.eg/article_206595.html

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https://asalexu.journals.ekb.eg/service?article_code=206595

Order

206,595

Type

Research articles

Type Code

2,129

Publication Type

Journal

Publication Title

Alexandria Scientific Nursing Journal

Publication Link

https://asalexu.journals.ekb.eg/

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Article

Created At

23 Jan 2023