Duration of oral endotracheal intubation is associated with dysphagia symptoms in acute lung injury patients

• Published in: Journal of critical care Vol. 29; no. 4; pp. 574 - 579
• Main Authors: Brodsky, Martin B., PhD, ScM, Gellar, Jonathan E., MPH, Dinglas, Victor D., MPH, Colantuoni, Elizabeth, PhD, Mendez-Tellez, Pedro A., MD, Shanholtz, Carl, MD, Palmer, Jeffrey B., MD, Needham, Dale M., MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2014; Elsevier Limited
• Subjects: Acute lung injury; Acute Lung Injury - therapy; Aged; Body mass index; Comorbidity; Confidence Intervals; Critical Care; Deglutition; Deglutition Disorders - diagnosis; Deglutition Disorders - etiology; Dysphagia; Female; Hospitals; Humans; Illnesses; Intensive care; Intubation; Intubation, Intratracheal - adverse effects; Intubation, Intratracheal - statistics & numerical data; Logistic Models; Male; Mechanical ventilation; Middle Aged; Odds Ratio; Older people; Ostomy; Patients; Prospective Studies; Respiration, Artificial - statistics & numerical data; Self Report; Time Factors; Variables; Ventilation; Deglutition; Acute lung injury; Dysphagia; Intubation; Mechanical ventilation
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2014.02.015

Abstract Purpose The purpose of this study is to evaluate demographic and clinical factors associated with self-reported dysphagia after oral endotracheal intubation and mechanical ventilation in patients with acute lung injury (ALI). Materials and methods This is a prospective cohort study of 132 ALI patients who had received mechanical ventilation via oral endotracheal tube. Results The primary outcome was binary, whether clinically important symptoms of dysphagia at hospital discharge were reported by patients, using the Sydney Swallowing Questionnaire score 200 or more. Of 132 patients, 29% reported clinically important symptoms of dysphagia. Of 18 relevant demographic and clinical variables, only 2 were found to be independently associated with clinically important symptoms of dysphagia in a multivariable logistic regression model: upper gastrointestinal comorbidity (odds ratio, 2.82; 95% confidence interval, 1.09-7.26) and duration of oral endotracheal intubation (odds ratio, 1.79; [95% confidence interval, 1.15-2.79] per day for first 6 days, after which additional days of intubation were not associated with a further increase in the odds of dysphagia). Conclusions In ALI survivors, patient-reported, postexubation dysphagia at hospital discharge was significantly associated with upper gastrointestinal comorbidity and a longer duration of oral endotracheal intubation during the first 6 days of intubation.