地域医療と健康教育

抽象的な

Post-Extubation Dysphagia in the Overdose Population

ReneeBrown,

Background: Post-extubation dysphagia (PED) has been studied in depth in a variety of populations including elective heart surgeries, trauma, critical illness, traumatic brain injury, and those requiring mechanical ventilation, but has not been researched in the overdose population (OD).

Methods: We reviewed the electronic medical records of 24 patients who were admitted to an acute care hospital between April 2016 and November 2019 due to drug overdose and subsequent intubation. Medical records of patients who met the OD diagnosis criteria, who were intubated, and who had received an instrumental evaluation of swallowing were selected. Data were extracted relating to the demographic profile, general clinical experience, and PED-specific evaluation and intervention of the sample. Risk factors commonly associated with PED were also extracted and described.

Results: Characteristics of the sample, prior to overdose and during the inpatient stay, provided an overview of the population in terms of demographics and acute care intervention. Forty-six percent of the sample scored a 4 or higher on the Penetration and Aspiration Scale with thin liquids on their initial instrumental examination. The number of sessions, including instrumental exams, ranged from 2 to 11, with forty-two percent of patients discharged from the facility prior to being discharged from speech-language pathology (SLP) services. Seventy-five percent of the sample was discharged on a regular diet and thin liquids. Seventeen percent of the samples were discharged with a recommendation of a mechanical soft diet and thin liquids while only eight percent completed their SLP course of treatment for dysphagia with a regular diet and nectar thick liquids.

Conclusions: This case series provides an overview of the OD PED population which has not been performed prior to this study. Although intubation was a factor resulting in dysphagia in this OD sample, the high percentage (seventy-five percent) of patients discharged on a regular diet suggests that PED is manageable when appropriate evaluation and intervention is provided.