Factors Contributing to Post Extubation Dysphagia in Critically Ill Patients | ||
| Alexandria Scientific Nursing Journal | ||
| Volume 21, Issue 2, December 2019, Pages 33-48 PDF (224.28 K) | ||
| Document Type: Research articles | ||
| DOI: 10.21608/asalexu.2019.206595 | ||
| Authors | ||
| Elham Ashraf Abdalla* 1; Nadia T Taha Mohamed1; Fatma Refaat El-Fattah1; Hany Samir Assaad2 | ||
| 1Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University | ||
| 2Critical Care Medicine, Faculty of Medicine, Alexandria University | ||
| 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. | ||
| Keywords | ||
| Critical illness; Dysphagia; Nursing care; Post-extubation dysphagia | ||
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