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Finding the red flags: Swallowing difficulties after cardiac surgery in patients with prolonged intubation.

Abstract：

PURPOSE:This retrospective audit set out to identify referral rates, swallowing characteristics, and risk factors for dysphagia and silent aspiration in at-risk patients after cardiac surgery. Dysphagia and silent aspiration are associated with poorer outcomes post cardiac surgery. METHODS:One hundred ninety patients who survived cardiac surgery and received more than 48 hours of intubation were included. Preoperative, perioperative, and postoperative information was collected. RESULTS:Forty-one patients (22%) were referred to speech-language pathology for a swallowing assessment. Twenty-four of these patients (13%) underwent instrumental swallowing assessment, and silent aspiration was observed in 17 (70% of patients diagnosed as having dysphagia via instrumental assessment). Multilogistic analysis revealed previous stroke (P < .05), postoperative stroke (P < .001), and tracheostomy (P < .001) independently associated with dysphagia. The odds ratio for being diagnosed as having pneumonia, if a patient was diagnosed as having dysphagia, was 3.3. CONCLUSIONS:Patients identified with dysphagia after cardiac surgery had a high incidence of silent aspiration and increased risk of pneumonia. However, referral rates were low in this at-risk patient group. Early identification and ongoing assessment and appropriate management of dysphagic patients by a speech-language pathologist are strongly recommended.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Daly E,Miles A,Scott S,Gillham M

doi

10.1016/j.jcrc.2015.10.008

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

119-24

issue

1

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(15)00537-7

journal_volume

31

pub_type

杂志文章

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