Dysphagia in the intensive care unit: epidemiology, mechanisms, and clinical management

Dysphagia may present in all critically ill patients and large-scale clinical data show that e.g. post-extubation dysphagia (PED) is commonly observed in intensive care unit (ICU) patients. Recent data demonstrate that dysphagia is mostly persisting and that its presence is independently associated...

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Vydáno v:	Critical care (London, England) Ročník 23; číslo 1; s. 103 - 11
Hlavní autoři:	Zuercher, Patrick, Moret, Céline S., Dziewas, Rainer, Schefold, Joerg C.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	London BioMed Central 28.03.2019 BioMed Central Ltd Springer Nature B.V BMC
Témata:	APACHE Care and treatment Critical care Critical Care Medicine Critical illness Critical Illness - epidemiology Deglutition disorder Deglutition disorders Deglutition Disorders - epidemiology Deglutition Disorders - physiopathology Deglutition Disorders - therapy Disease Management Distribution Dysphagia Emergency Medicine Epidemiology Esophagus Gastroesophageal reflux Hospitals Humans Iatrogenic Disease - epidemiology Iatrogenic Disease - prevention & control ICU-acquired swallowing dysfunction ICU-acquired weakness Illnesses Intensive Intensive care Intensive Care Units - organization & administration Intubation Medicine Medicine & Public Health Methods Morbidity Mortality Organ Dysfunction Scores Ostomy Patient-centered care Pneumonia Public health Respiration, Artificial - adverse effects Respiration, Artificial - methods Review Sepsis Stroke Terminology Terms and phrases Trauma Traumatic brain injury Germany Critical illness Sepsis ICU-acquired weakness Deglutition disorder ICU-acquired swallowing dysfunction
ISSN:	1364-8535, 1466-609X, 1364-8535, 1466-609X, 1366-609X
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Shrnutí:	Dysphagia may present in all critically ill patients and large-scale clinical data show that e.g. post-extubation dysphagia (PED) is commonly observed in intensive care unit (ICU) patients. Recent data demonstrate that dysphagia is mostly persisting and that its presence is independently associated with adverse patient-centered clinical outcomes. Although several risk factors possibly contributing to dysphagia development were proposed, the underlying exact mechanisms in ICU patients remain incompletely understood and no current consensus exists on how to best approach ICU patients at risk. From a clinical perspective, dysphagia is well-known to be associated with an increased risk of aspiration and aspiration-induced pneumonia, delayed resumption of oral intake/malnutrition, decreased quality of life, prolonged ICU and hospital length of stay, and increased morbidity and mortality. Moreover, the economic burden on public health care systems is high. In light of high mortality rates associated with the presence of dysphagia and the observation that dysphagia is not systematically screened for on most ICUs, this review describes epidemiology, terminology, and potential mechanisms of dysphagia on the ICU. Furthermore, the impact of dysphagia on affected individuals, health care systems, and society is discussed in addition to current and future potential therapeutic approaches.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23
ISSN:	1364-8535 1466-609X 1364-8535 1466-609X 1366-609X
DOI:	10.1186/s13054-019-2400-2