[Summary] Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours?

Swallowing Evaluation Post-Extubation

Reading: Leder, S. B., Warner, H. L., Suiter, D. M., Young, N. O., Bhattacharya, B., Siner, J. M., Davis, K. A., Maerz, L. L., Rosenbaum, S. H., Marshall, P. S., Pisani, M. A., Siegel, M. D., Brennan, J. J., & Schuster, K. M. (2019). Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours?. The Annals of otology, rhinology, and laryngology, 128(7), 619–624. https://doi.org/10.1177/0003489419836115

Objective: Determine if it is necessary to delay swallow evaluation for 24 hours post-extubation.

Participants: 202 adults from 5 different intensive care units (ICU).

Method: Prospective investigation of swallowing at 1, 4, and 24 hours post-extubation

Conclusion: NOT necessary to delay swallow evaluation for 24 hours post-extubation

Why?
👉🏻Majority of patients (82.2%) passed a swallow screening at 1 hour post-extubation.
👉🏻Majority of patients (86.9%) recommended with oral diet post-Yale swallow protocol resumed oral alimentation without signs of aspiration from day of testing until day of discharge

Implication: Swallow screen as soon as 1 hour after extubation is feasible!

Why don’t we wait? Earlier intervention possibly…
Shorten hospital stay —> more efficient use of hospital resources
Avoids interim feeding tube placement

Limitation of study:
👉🏻93.6% participants GCS b/w 13-15 —> result might not be applicable to px with lower GCS status

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