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Journal of critical care · Feb 2024
ReviewManagement of swallowing disorders in ICU patients - A multinational expert opinion.
- Rudolf Likar, Ilia Aroyo, Katrin Bangert, Björn Degen, Rainer Dziewas, Oliver Galvan, Michaela Trapl Grundschober, Markus Köstenberger, Paul Muhle, Joerg C Schefold, and Patrick Zuercher.
- Department for Anaesthesiology and Intensive Medicine, Klinikum Klagenfurt am Wörthersee, Austria.
- J Crit Care. 2024 Feb 1; 79: 154447154447.
BackgroundDysphagia 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.PurposeTo propose an expert opinion for the diagnosis and management of dysphagia developed from evidence-based clinical recommendations and practitioner insights.MethodsA 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.ResultsThe 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.ConclusionsGiven 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.Copyright © 2023. Published by Elsevier Inc.
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