Hostname: page-component-8448b6f56d-jr42d Total loading time: 0 Render date: 2024-04-24T09:29:02.671Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence and evaluation of oropharyngeal dysphagia in patients with severe acute respiratory syndrome coronavirus 2 infection in the intensive care unit

Part of: JLO Coronavirus Collection

Published online by Cambridge University Press:  10 January 2022

R Mallart Open the ORCID record for R Mallart [Opens in a new window] ,
C Rossignol ,
J B Poppe ,
G Prum ,
F Tamion ,
B Veber  and
E Verin
R Mallart
Affiliation:
Pôle 3R (Rééducation, Réadaptation Réinsertion), Rouen University Hospital, Rouen, France
C Rossignol
Affiliation:
Pôle 3R (Rééducation, Réadaptation Réinsertion), Rouen University Hospital, Rouen, France
J B Poppe
Affiliation:
Pôle 3R (Rééducation, Réadaptation Réinsertion), Rouen University Hospital, Rouen, France
G Prum
Affiliation:
Pôle 3R (Rééducation, Réadaptation Réinsertion), Rouen University Hospital, Rouen, France
F Tamion
Affiliation:
Medical Resuscitation Service, Normandy University (UNIROUEN), Rouen University Hospital, Rouen, France
B Veber
Affiliation:
Department of Anesthesiology and Intensive Care, Rouen University Hospital, Rouen, France
E Verin*
Affiliation:
Pôle 3R (Rééducation, Réadaptation Réinsertion), Rouen University Hospital, Rouen, France EA3830 – Research Group on Ventilatory Handicap (GRHV), Normandy University (UNIROUEN), Rouen, France
*
Author for correspondence: Prof Eric Verin, Pôle 3R, CHU de Rouen, 1 rue de Germont, 76031 Cedex, Rouen, France E-mail: eric.verin@univ-rouen.fr
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

The main objective was to assess the prevalence of dysphagia in the intensive care unit in patients with coronavirus disease 2019.

Methods. A cohort, observational, retrospective study was conducted of patients admitted to the intensive care unit for severe acute respiratory syndrome coronavirus 2 pneumonia at the University Hospital of Rouen in France.

Results

Over 4 months, 58 patients were intubated and ventilated, 43 of whom were evaluated. Screening revealed post-extubation dysphagia in 62.7 per cent of patients. In univariate analysis, a significant association was found between the presence of dysphagia and: the severity of the initial pathology, the duration of intubation, the duration of curare use, the degree of muscle weakness and the severity indicated on the initial scan. At the end of intensive care unit treatment, 22 per cent of the dysphagic patients had a normal diet, 56 per cent had an adapted diet and 22 per cent still received exclusive tube feeding.

Conclusion

Post-extubation dysphagia is frequent and needs to be investigated.

Keywords

DysphagiaIntensive Care UnitsSARS-CoV-2Post-Extubation DysphagiaPrevalence
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 7 , July 2022 , pp. 649 - 653
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Prof E Verin takes responsibility for the integrity of the content of the paper

References

Macht, M, Wimbish, T, Clark, BJ, Benson, AB, Burnham, EL, Williams, A et al. Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Crit Care 2011;15:R231CrossRefGoogle ScholarPubMed
Macht, M, Wimbish, T, Bodine, C, Moss, M. ICU-acquired swallowing disorders. Crit Care Med 2013;41:2396–405CrossRefGoogle ScholarPubMed
Ickenstein, GW, Riecker, A, Höhlig, C, Müller, R, Becker, U, Reichmann, H et al. Pneumonia and in-hospital mortality in the context of neurogenic oropharyngeal dysphagia (NOD) in stroke and a new NOD step-wise concept. J Neurol 2010;257:1492–9CrossRefGoogle Scholar
Rassameehiran, S, Klomjit, S, Mankongpaisarnrung, C, Rakvit, A. Postextubation dysphagia. Proc (Bayl Univ Med Cent) 2015;28:18–20Google ScholarPubMed
Partik, B, Pokieser, P, Schima, W, Schober, E, Stadler, A, Eisenhuber, E et al. Videofluoroscopy of swallowing in symptomatic patients who have undergone long-term intubation. AJR Am J Roentgenol 2000;174:1409–12CrossRefGoogle ScholarPubMed
Tolep, K, Getch, CL, Criner, GJ. Swallowing dysfunction in patients receiving prolonged mechanical ventilation. Chest 1996;109:167–72CrossRefGoogle ScholarPubMed
Hafner, G, Neuhuber, A, Hirtenfelder, S, Schmedler, B, Eckel, HE. Fiberoptic endoscopic evaluation of swallowing in intensive care unit patients. Eur Arch Otorhinolaryngol 2008;265:441–6CrossRefGoogle ScholarPubMed
Brunello, A-G, Haenggi, M, Wigger, O, Porta, F, Takala, J, Jakob, SM. Usefulness of a clinical diagnosis of ICU-acquired paresis to predict outcome in patients with SIRS and acute respiratory failure. Intensive Care Med 2010;36:66–74CrossRefGoogle ScholarPubMed
Huang, C, Wang, Y, Li, X, Ren, L, Zhao, J, Hu, Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497–506CrossRefGoogle ScholarPubMed
Li, X, Ma, X. Acute respiratory failure in COVID-19: is it ‘typical’ ARDS? Crit Care 2020;24:198CrossRefGoogle ScholarPubMed
Grasselli, G, Zangrillo, A, Zanella, A, Antonelli, M, Cabrini, L, Castelli, A et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA 2020;323:1574–81CrossRefGoogle ScholarPubMed
Helms, J, Kremer, S, Merdji, H, Clere-Jehl, R, Schenck, M, Kummerlen, C et al. Neurologic features in severe SARS-CoV-2 infection. N Engl J Med 2020;382:2268–70CrossRefGoogle ScholarPubMed
Scheel, R, Pisegna, JM, McNally, E, Noordzij, JP, Langmore, SE. Endoscopic assessment of swallowing after prolonged intubation in the ICU setting. Ann Otol Rhinol Laryngol 2016;125:43–52CrossRefGoogle ScholarPubMed
Colton House, J, Noordzij, JP, Murgia, B, Langmore, S. Laryngeal injury from prolonged intubation: a prospective analysis of contributing factors. Laryngoscope 2011;121:596–600CrossRefGoogle ScholarPubMed
Medeiros, GC, Sassi, FC, Mangilli, LD, Zilberstein, B, Andrade, CR. Clinical dysphagia risk predictors after prolonged orotracheal intubation. Clinics (Sao Paulo) 2014;69:8–14CrossRefGoogle ScholarPubMed
Marvin, S, Thibeault, S, Ehlenbach, WJ. Post-extubation dysphagia: does timing of evaluation matter? Dysphagia 2019;34:210–19CrossRefGoogle ScholarPubMed
Skoretz, SA, Flowers, HL, Martino, R. The incidence of dysphagia following endotracheal intubation: a systematic review. Chest 2010;137:665–73CrossRefGoogle ScholarPubMed
Brodsky, MB, Gellar, JE, Dinglas, VD, Colantuoni, E, Mendez-Tellez, PA, Shanholtz, C et al. Duration of oral endotracheal intubation is associated with dysphagia symptoms in acute lung injury patients. J Crit Care 2014;29:574–9CrossRefGoogle ScholarPubMed
Brodsky, MB, Huang, M, Shanholtz, C, Mendez-Tellez, PA, Palmer, JB, Colantuoni, E et al. Recovery from dysphagia symptoms after oral endotracheal intubation in acute respiratory distress syndrome survivors. A 5-year longitudinal study. Ann Am Thorac Soc 2017;14:376–83CrossRefGoogle ScholarPubMed
Barker, J, Martino, R, Reichardt, B, Hickey, EJ, Ralph-Edwards, A. Incidence and impact of dysphagia in patients receiving prolonged endotracheal intubation after cardiac surgery. Can J Surg 2009;52:119–24Google ScholarPubMed
Omura, K, Komine, A, Yanagigawa, M, Chiba, N, Osada, M. Frequency and outcome of post-extubation dysphagia using nurse-performed swallowing screening protocol. Nurs Crit Care 2019;24:70–5CrossRefGoogle ScholarPubMed
Macht, M, King, CJ, Wimbish, T, Clark, BJ, Benson, AB, Burnham, EL et al. Post-extubation dysphagia is associated with longer hospitalization in survivors of critical illness with neurologic impairment. Crit Care 2013;17:R119CrossRefGoogle ScholarPubMed
Ajemian, MS, Nirmul, GB, Anderson, MT, Zirlen, DM, Kwasnik, EM. Routine fiberoptic endoscopic evaluation of swallowing following prolonged intubation: implications for management. Arch Surg 2001;136:434–7CrossRefGoogle ScholarPubMed
Zhao, W, Zhong, Z, Xie, X, Yu, Q, Liu, J. Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: a multicenter study. AJR Am J Roentgenol 2020;214:1072–7CrossRefGoogle ScholarPubMed
Francone, M, Iafrate, F, Masci, GM, Coco, S, Cilia, F, Manganaro, L et al. Chest CT score in COVID-19 patients: correlation with disease severity and short-term prognosis. Eur Radiol 2020;30:6808–17CrossRefGoogle ScholarPubMed
Guillo, E, Bedmar Gomez, I, Dangeard, S, Bennani, S, Saab, I, Tordjman, M et al. COVID-19 pneumonia: diagnostic and prognostic role of CT based on a retrospective analysis of 214 consecutive patients from Paris, France. Eur J Radiol 2020;131:109209CrossRefGoogle ScholarPubMed
Hur, K, Price, CPE, Gray, EL, Gulati, RK, Maksimoski, M, Racette, SD et al. Factors associated with intubation and prolonged intubation in hospitalized patients with COVID-19. Otolaryngol Head Neck Surg 2020;163:170–8CrossRefGoogle ScholarPubMed