Management of swallowing disorders in ICU patients - A multinational expert opinion.

Likar, Rudolf; Aroyo, Ilia; Bangert, Katrin; Degen, Björn; Dziewas, Rainer; Galvan, Oliver; Grundschober, Michaela Trapl; Köstenberger, Markus; Muhle, Paul; Schefold, Joerg C; Zürcher, Patrick (2024). Management of swallowing disorders in ICU patients - A multinational expert opinion. Journal of critical care, 79(154447), p. 154447. Elsevier 10.1016/j.jcrc.2023.154447

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BACKGROUND

Dysphagia is common in intensive care unit (ICU) patients, yet it remains underrecognized and often unmanaged despite being associated with life-threatening complications, prolonged ICU stays and hospitalization.

PURPOSE

To propose an expert opinion for the diagnosis and management of dysphagia developed from evidence-based clinical recommendations and practitioner insights.

METHODS

A multinational group of dysphagia and critical care experts conducted a literature review using a modified ACCORD methodology. Based on a fusion of the available evidence and the panel's clinical experience, an expert opinion on best practice management was developed.

RESULTS

The panel recommends adopting clinical algorithms intended to promote standardized, high-quality care that triggers timely systematic dysphagia screening, assessment, and treatment of extubated and tracheostomized patients in the ICU.

CONCLUSIONS

Given the lack of robust scientific evidence, two clinical management algorithms are proposed for use by multidisciplinary teams to improve early systematic detection and effective management of dysphagia in ICU patients. Additionally, emerging therapeutic options such as neurostimulation have the potential to improve the quality of ICU dysphagia care.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Schefold, Jörg Christian, Zürcher, Patrick

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0883-9441

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

06 Nov 2023 10:20

Last Modified:

12 Dec 2023 00:15

Publisher DOI:

10.1016/j.jcrc.2023.154447

PubMed ID:

37924574

Uncontrolled Keywords:

Critically ill patients Dysphagia Dysphagia treatment Evidence-based clinical recommendations Expert consensus ICU Pharyngeal electrical stimulation Post-extubation Swallowing therapy Tracheostomy

BORIS DOI:

10.48350/188581

URI:

https://boris.unibe.ch/id/eprint/188581

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