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Dysphagia

, Volume 13, Issue 4, pp 208–212 | Cite as

Fiberoptic Endoscopic Documentation of the High Incidence of Aspiration following Extubation in Critically Ill Trauma Patients

  • Steven B.  Leder
  • Stephen M.  Cohn
  • Beth A.  Moller

Abstract.

The purpose of this study was to investigate the incidence of aspiration following extubation in critically ill trauma patients. This prospective pilot study included 20 consecutive trauma patients who required orotracheal intubation for at least 48 hours. All subjects underwent a bedside transnasal fiberoptic endoscopic evaluation of swallowing at 24 ± 2 hr after extubation to determine objectively aspiration status. Aspiration was defined as the entry of a blue dyed material into the airway below the level of the true vocal folds, with silent aspiration occurring in the absence of any external behavioral signs such as coughing or choking. Aspiration was identified in 9 of 20 (45%) subjects and 4 of these 9 (44%) were silent aspirators. Therefore, silent aspiration occurred in 20% of the study population. Eight of the 9 (89%) aspirating subjects resumed an oral diet from 2–10 days (mean, 5 days) following extubation. All subjects had no evidence of pulmonary complications. It was concluded that trauma patients after orotracheal intubation and prolonged mechanical ventilation have an increased risk of aspiration. An objective assessment of dysphagia to identify aspiration may reduce the likelihood of pulmonary complications after extubation.

Key words: Aspiration — Silent aspiration — Fiberoptic endoscope — Trauma — Orotracheal intubation — Extubation — Deglutition — Deglutition disorders. 

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Copyright information

© Springer-Verlag New York Inc. 1998

Authors and Affiliations

  • Steven B.  Leder
    • 1
  • Stephen M.  Cohn
    • 2
  • Beth A.  Moller
    • 3
  1. 1.Yale University School of Medicine, Department of Surgery, Section of Otolaryngology, Communication Disorders Center, New Haven, Connecticut, USAUS
  2. 2.University of Miami School of Medicine, Division of Trauma and Surgical Critical Care, Department of Surgery, Miami, Florida, USAUS
  3. 3.Yale University School of Medicine, Department of Surgery, Section of Trauma and Critical Care, New Haven, Connecticut, USAUS

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