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Best Practice Recommendations for Dysphagia Management in Intensive Care Unit (ICU): A Delphi Study from Multidisciplinary Experts in Turkey

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Abstract

There is no study about all aspects of oropharyngoesophageal (OPE) dysphagia from diagnosis to follow-up in a multidisciplinary manner in the world. In order to close this gap, we aimed to create a recommendation study that can be used in clinical practice, addressing all aspects of dysphagia in the ICU in detail with the opinion of experienced multidisciplinary experts. This recommendation paper was generated by a multidisciplinary team, using the seven-step process and a three-modified Delphi round via e-mail. Firstly, 15 open-ended questions were created, and then detailed recommendations including general principles, management, diagnosis, rehabilitation, and follow-up were created with the answers from these questions, Each recommendation item was voted on by the experts as overall consensus (strong recommendation), approaching consensus (weak recommendation), and divergent consensus (not recommended).In the first Delphi round, a questionnaire consisting of 413 items evaluated with a scale of 0–10 was prepared from the opinions and suggestions given to 15 open-ended questions. In the second Delphi round, 55.4% were accepted and revised suggestions were created. At the end of the third Delphi round, the revised suggestion form was approved again and the final proposals containing 133 items were created. This study includes comprehensive and detailed recommendations, including a broad perspective from diagnosis to treatment and follow-up, as detailed as possible, for management of dysphagia in patients with both oropharyngeal- and esophageal-dysphagia in ICU.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

There is no funding source in this study.

Author information

Authors and Affiliations

  1. Ankara Etlik City Physical Medicine and Rehabilitation Hospital, University of Health Sciences Turkey, Halil Sezai Erkut Street, No. 5, 06170, Yenimahalle, Ankara, Turkey

    Ebru Umay, Ibrahim Gundogdu, Cuma Uz, Aslihan Uzunkulaoglu & Emre Adiguzel

  2. Department of Physical Medicine and Rehabilitation, Ege University, Izmir, Turkey

    Sibel Eyigor

  3. Department of Anesthesiology and Reanimation, Ege University, Izmir, Turkey

    Kubilay Demirag

  4. Department of Physical Medicine and Rehabilitation, Gazi University, Ankara, Turkey

    Gulcin Kaymak Karatas

  5. Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey

    Esra Giray

  6. Department of Neurology, Ankara Etlik City Hospital, University of Health Sciences Turkey, Ankara, Turkey

    Mehlika Panpalli Ates, Bilge Gonenli Kocer & Fevzi Oztekin

  7. Gaziler Physical Medicine and Rehabilitation Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey

    Eda Gurcay

  8. Department of Physical Medicine and Rehabilitation, Celal Bayar University, Manisa, Turkey

    Zeliha Unlu

  9. Department of Speech and Language Therapy, Fenerbahce University, Istanbul, Turkey

    Serkan Bengisu

  10. Department of Gastroenterology, Medicana International Ankara Hospital, Ankara, Turkey

    Fatih Karaahmet

  11. Department of Physical Medicine and Rehabilitation, Basaksehir Cam Sakura Hospital, Istanbul, Turkey

    Fatih Bagcier

  12. Department of Physical Medicine and Rehabilitation, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

    Meltem Vural & Banu Aydeniz

  13. Department of Neurosurgery, Ankara Medical Park Hospital, Ankara, Turkey

    Humeyra Kullukcu

  14. Department of Otolaryngology, Head and Neck Surgery, Ankara Etlik City Hospital, University of Health Sciences Turkey, Ankara, Turkey

    Sibel Alicura

  15. Department of Speech and Language Therapy, Ankara Etlik City Hospital, University of Health Sciences Turkey, Ankara, Turkey

    Elife Barmak

Authors
  1. Ebru Umay
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  2. Sibel Eyigor
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  3. Kubilay Demirag
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  4. Gulcin Kaymak Karatas
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  7. Mehlika Panpalli Ates
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  8. Bilge Gonenli Kocer
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  9. Eda Gurcay
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  10. Zeliha Unlu
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  11. Serkan Bengisu
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  12. Fatih Karaahmet
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  13. Fatih Bagcier
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  14. Meltem Vural
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  15. Banu Aydeniz
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  16. Humeyra Kullukcu
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  17. Fevzi Oztekin
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  18. Sibel Alicura
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  19. Cuma Uz
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  20. Elife Barmak
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  21. Aslihan Uzunkulaoglu
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  22. Emre Adiguzel
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Contributions

EU, SE: Conceptualization, Methodology, Investigation, Formal analysis, Validation, Writing—original draft, Writing—review & editing. KD, GKK, IG, EG, MPA, BGK, EG, ZU, SB, FK, FB, MV, BA, HK, FO, SA, CU, EB, AU, EA: Writing—review & editing.

Corresponding author

Correspondence to Ebru Umay.

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There is no competing interests among the authors.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (IRC:2021–120/12) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Umay, E., Eyigor, S., Demirag, K. et al. Best Practice Recommendations for Dysphagia Management in Intensive Care Unit (ICU): A Delphi Study from Multidisciplinary Experts in Turkey. Dysphagia 39, 241–254 (2024). https://doi.org/10.1007/s00455-023-10606-w

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  • DOI: https://doi.org/10.1007/s00455-023-10606-w

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