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Neurologische Beatmungsmedizin pp 89–103Cite as

Schlucken und Schluckstörungen

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Zusammenfassung

In der Intensivmedizin stellen Schluckstörungen ein außerordentlich häufiges und prognostisch bedeutsames Symptom dar. Die Dysphagie des Intensivpatienten ist ein ätiologisch heterogenes Störungsbild. Die vielfältigen Ursachen lassen sich in drei Kategorien differenzieren. So können die mit der Intensivtherapie assoziierten (neurologischen) Hauptdiagnose, spezifische (neurologische) Komorbiditäten und die konkreten Folgen der Intensivtherapie selbst hauptursächlich für die Beeinträchtigung des Schluckakts sein. Als diagnostische Verfahren stehen klinische Tests und instrumentelle Verfahren, insbesondere die FEES, zur Verfügung. Das Dysphagiemanagement auf der Intensivstation erfolgt interdisziplinär. Pflegekräfte, Therapeuten und Ärzte arbeiten hier eng zusammen, um für jeden Patienten die richtige Balance zwischen Aspirationsprävention auf der einen und zügigem oralem Kostaufbau auf der anderen Seite zu finden.

Dieses Kapitel wurde modifziert und ergänzt nach: Dziewas R, Glahn J (2015) Dysphagiemanagement. In: Schwab S, Schellinger P, Werner C, Unterberg A, Hacke W (Hrsg.) NeuroIntensiv. Springer, Berlin Heidelberg.

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Literatur

  • Ajemian MS, Nirmul GB, Anderson MT, Zirlen DM, Kwasnik EM (2001) Routine fiberoptic endoscopic evaluation of swallowing following prolonged intubation: implications for management. Arch Surg 136:434–437

    Article  CAS  PubMed  Google Scholar 

  • Aviv JE, Kaplan ST, Thomson JE, Spitzer J, Diamond B, Close LG (2000) The safety of flexible endoscopic evaluation of swallowing with sensory testing (FEESST): an analysis of 500 consecutive evaluations. Dysphagia 15:39–44

    Article  CAS  PubMed  Google Scholar 

  • Aviv JE, Kaplan ST, Langmore SE (2001) The safety of endoscopic swallowing evaluations. In: Langmore SE (Hrsg) Endoscopic evaluation and treatment of swallowing disorders. Thieme, Stuttgart, S 235–242

    Google Scholar 

  • Barquist E, Brown M, Cohn S, Lundy D, Jackoski J (2001) Postextubation fiberoptic endoscopic evaluation of swallowing after prolonged endotracheal intubation: a randomized prospective trail. Crit Care Med 29:1710–1713

    Article  CAS  PubMed  Google Scholar 

  • Bechet S, Hill F, Gilheaney O, Walshe M (2016) Diagnostic accuracy of the modified Evan’s blue dye test in detecting aspiration in patients with tracheostomy: a systematic review of the evidence. Dysphagia 31(6):721–729

    Article  PubMed  Google Scholar 

  • Boden K, Cedborg AI, Eriksson LI, Hedström HW, Kuylenstierna R, Sundman E, Ekberg O (2009) Swallowing and respiratory pattern in young healthy individuals recorded with high temporal resolution. Neurogastroenterol Motil 21:1163–e1101

    Article  CAS  PubMed  Google Scholar 

  • Bours GJJW, Speyer R, Lemmens J, Limburg M, de Wit R (2009) Bedside screening tests vs. videofluoroscopy or fiberoptic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: a systematic review. JAN 65:477–493

    Article  Google Scholar 

  • Brady S, Hildner C, Hutchins B (1999) Simultaneous videofluoroscopic swallow study and modified Evans blue dye procedure: an evaluation of blue dye visualization in cases of known aspiration. Dysphagia 14:146–149

    Article  CAS  PubMed  Google Scholar 

  • Brodsky MB, Huang M, Shanholtz C, Mendez-Tellez PA, Palmer JB, Colantuoni E, Needham DM (2017) Recovery from dysphagia symptoms after oral endotracheal intubation in acute respiratory distress syndrome survivors. A 5-year longitudinal study. Ann Am Thorac Soc 14(3):376–383

    Article  PubMed  PubMed Central  Google Scholar 

  • Broussard DL, Altschuler SM (2000) Brainstem viscerotopic organization of afferents and efferents involved in the control of swallowing. Am J Med 108(Suppl 4a):79S–86S

    Article  PubMed  Google Scholar 

  • Cassier-Woidasky AK, Nahrwold J, Glahn J (2012) Pflege von Patienten mit Schlaganfall; von der Stroke Unit bis zur Rehabilitation. Kohlhammer, Stuttgart

    Google Scholar 

  • Christensen M, Trapl M (2017) Development of a modified swallowing screening tool to manage post-extubation dysphagia. Nurs Crit Care 23(2):102–107

    Article  PubMed  Google Scholar 

  • Cohen MA, Setzen M, Perlman PW (2003) The safety of flexible endoscopic evaluation of swallowing with sensory testing in an outpatient otolaryngology setting. Laryngoscope 113:21–24

    Article  PubMed  Google Scholar 

  • Dodds WJ (1989) Physiology of swallowing. Dysphagia 3:171–178

    Article  CAS  PubMed  Google Scholar 

  • Donzelli J, Brady S, Wesling M, Craney M (2001) Simultaneous modified Evans blue dye procedure and video nasal endoscopic evaluation of the swallow. Laryngoscope 111:1746–1750

    Article  CAS  PubMed  Google Scholar 

  • Dziewas R, Glahn J (2015) Dysphagiemanagement. In: Schwab S, Schellinger P, Werner C, Unterberg A, Hacke W (Hrsg) NeuroIntensiv. Springer, Berlin, S 108–114

    Google Scholar 

  • Dziewas R, Ludemann P (2002) Hypoglossal nerve palsy as complication of oral intubation, bronchoscopy and use of the laryngeal mask airway. Eur Neurol 47(4):239–243

    Article  PubMed  Google Scholar 

  • Dziewas R, Warnecke T, Oelenberg S, Teismann I, Zimmermann J, Kraemer C, Ritter M, Ringelstein EB, Schabitz WR (2008) Towards a basic endoscopic assessment of swallowing in acute stroke – development and evaluation of a simple dysphagia score. Cerebrovasc Dis 26:41–47

    Article  PubMed  Google Scholar 

  • El Solh A, Okada M, Bhat A, Pietratoni C (2003) Swallowing disorders post orotracheal intubation in the elderly. Intensive Care Med 29:1451–1455

    Article  PubMed  Google Scholar 

  • Gross RD, Atwood CW, Ross SB, Olszweski JW, Eichhorn KA (2009) The coordination of breathing and swallowing in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 179:559–565

    Article  PubMed  Google Scholar 

  • Hafner G, Neuhuber A, Hirtenfelder S, Schmedler B, Eckel HE (2008) Fiberoptic endoscopic evaluation of swallowing in intensive care unit patients. Eur Arch Otorhinolaryngol 265:441–446

    Article  PubMed  Google Scholar 

  • Hales PA, Drinnan MJ, Wilson JA (2008) The added value of fibreoptic endoscopic evaluation of swallowing in tracheostomy weaning. Clin Otolaryngol 33:319–324

    Article  CAS  PubMed  Google Scholar 

  • Kelly AM, Leslie P, Beale T, Payten C, Drinnan MJ (2006) Fibreoptic endoscopic evaluation of swallowing and videofluoroscopy: does examination type influence perception of pharyngeal residue severity? Clin Otolaryngol 31:425–432

    Article  CAS  PubMed  Google Scholar 

  • Kelly AM, Drinnan MJ, Leslie P (2007) Assessing penetration and aspiration: how do videofluoroscopy and fiberoptic endoscopic evaluation of swallowing compare? Laryngoscope 117:1723–1727

    Article  PubMed  Google Scholar 

  • Kim MJ, Park YH, Park YS, Song YH (2015) Associations between prolonged intubation and developing post-extubation dysphagia and aspiration pneumonia in non-neurologic critically lll patients. Ann Rehabil Med 39(5):763–771

    Article  PubMed  PubMed Central  Google Scholar 

  • Langmore SE (2001) Endoscopic evaluation and treatment of swallowing disorders. Thieme, Stuttgart

    Google Scholar 

  • Langmore SE (2017) History of fiberoptic endoscopic evaluation of swallowing for evaluation and management of pharyngeal dysphagia: changes over the years. Dysphagia 32(1):27–38

    Article  PubMed  Google Scholar 

  • Leder S, Suiter DM, Lisitano Warner H (2009) Answering orientation questions and following single-step verbal commands: effect on aspiration status. Dysphagia 24:290–295

    Article  PubMed  Google Scholar 

  • Leder SB, Sasaki CT, Burrell MI (1998) Fiberoptic endoscopic evaluation of dysphagia to identify silent aspiration. Dysphagia 13:19–21

    Article  CAS  PubMed  Google Scholar 

  • Lynch YT, Clark BJ, Macht M, White SD, Taylor H, Wimbish T, Moss M (2017) The accuracy of the bedside swallowing evaluation for detecting aspiration in survivors of acute respiratory failure. J Crit Care 39:143–148

    Article  PubMed  PubMed Central  Google Scholar 

  • Macht M, Wimbish T, Clark BJ, Benson AB, Burnham EL, Williams A, Moss M (2011) Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Crit Care 15:R231

    Article  PubMed  PubMed Central  Google Scholar 

  • Macht M, Wimbish T, Bodine C, Moss M (2013) ICU-acquired swallowing disorders. Crit Care Med 41:2396–2405

    Article  PubMed  Google Scholar 

  • McCullough GH, Wertz RT, Rosenbeck JC, Mills RH, Ross KB, Ashford JR (2000) Inter- and intrajudge reliability of a clinical swallowing examination of swallowing in adults. Dysphagia 15:58–67

    Article  CAS  PubMed  Google Scholar 

  • McCullough GH, Wertz RT, Rosenbek JC (2001) Sensitivity and specificity of clinical/bedside examination signs for detecting aspiration in adults subsequent to stroke. J Commun Disord 34:55–72

    Article  CAS  PubMed  Google Scholar 

  • Metheny NA (2006) Preventing respiratory complications of tube-feedings: evidence-based practice. Am J Crit Care 15:360–369

    Article  PubMed  Google Scholar 

  • Metheny NA, Clouse RE, Chang CH, Stewart BJ, Oliver DA, Kollef MH (2006) Tracheobronchial aspiration of gastric contents in critically ill tube-fed patients: frequency, outcomes, and risk factors. Crit Care Med 34:1007–1015

    Article  PubMed  PubMed Central  Google Scholar 

  • Noordally SO, Sohawon S, De Gieter M, Bellout H, Verougstraete C (2011) A study to determine the correlation between clinical, fiber-optic endoscopic evaluation of swallowing and videofluoroscopic evaluations of swallowing after prolonged intubation. Nutr Clin Pract 26:457–462

    Article  PubMed  Google Scholar 

  • Peruzzi W, Logemann JA, Currie D, Moen S (2001) Assessement of aspiration in patients with tracheostomies: comparison of the bedside colored dye assessment with videofluoroscopic examination. Respir Care 46:243–247

    CAS  PubMed  Google Scholar 

  • Peterson SJ, Tsai AA, Scala CM, Sowa DC, Sheean PM, Braunschweig CL (2010) Adequacy of oral intake in critically ill patients 1 week after extubation. J Am Diet Assoc 110(3):427–433

    Article  PubMed  Google Scholar 

  • Prosiegel M, Weber S (2010) Dysphagie. Diagnostik und Therapie. Springer, Berlin

    Book  Google Scholar 

  • Sakakura K, Tazawa M, Otani N, Takagi M, Morita M, Kurosaki M, Chiyoda T, Kanai Y, Endo A, Murata T, Shino M, Yokobori Y, Shirakura K, Wada N, Chikamatsu K (2017) Impact of a multidisciplinary round visit for the management of dysphagia utilizing a Wi-Fi-based wireless flexible endoscopic evaluation of swallowing. Ann Otol Rhinol Laryngol 126(1):47–53

    Article  PubMed  Google Scholar 

  • Scheel R, Pisegna JM, McNally E, Noordzij JP, Langmore SE (2016) Endoscopic assessment of swallowing after prolonged intubation in the ICU setting. Ann Otol Rhinol Laryngol 125(1):43–52

    Article  PubMed  Google Scholar 

  • Schefold JC, Berger D, Zurcher P, Lensch M, Perren A, Jakob SM, Parviainen I, Takala J (2017) Dysphagia in mechanically ventilated ICU patients (DYnAMICS): a prospective observational trial. Crit Care Med 45(12):2061–2069

    Article  PubMed  Google Scholar 

  • See KC, Peng SY, Phua J, Sum CL, Concepcion J (2016) Nurse-performed screening for postextubation dysphagia: a retrospective cohort study in critically ill medical patients. Crit Care 20(1):326

    Article  PubMed  PubMed Central  Google Scholar 

  • Shaker R, Li Q, Ren J, Townsend WF, Dodds WJ, Martin BJ, Kern MK, Rynders A (1992) Coordination of deglutition and phases of respiration: effect of aging, tachypnea, bolus volume, and chronic obstructive pulmonary disease. Am J Physiol 263:G750–G755

    Article  CAS  PubMed  Google Scholar 

  • Skoretz SA, Flowers JL, Martino R (2010) The incidence of dysphagia following endotracheal intubation: a systematic review. Chest 137:665–673

    Article  PubMed  Google Scholar 

  • Warnecke T, Ritter M, Kroger B, Oelenberg S, Teismann I, Heuschmann PU, Ringelstein EB, Nabavi DG, Dziewas R (2009a) Fiberoptic endoscopic dysphagia severity scale predicts outcome after acute stroke. Cerebrovasc Dis 28:283–289

    Article  PubMed  Google Scholar 

  • Warnecke T, Teismann I, Oelenberg S, Hamacher C, Ringelstein EB, Schabitz WR, Dziewas R (2009b) The safety of fiberoptic endoscopic evaluation of swallowing in acute stroke patients. Stroke 40:482–486

    Article  PubMed  Google Scholar 

  • Warnecke T, Dziewas R (2013) Neurogene Dysphagien. Diagnostik und Therapie. Kohlhammer, Stuttgart

    Google Scholar 

  • Warnecke T, Suntrup S, Teismann IK, Hamacher C, Oelenberg S, Dziewas R (2013) Standardized endoscopic swallowing evaluation for tracheostomy decannulation in critically ill neurologic patients. Crit Care Med 41(7):1728–1732

    Article  PubMed  Google Scholar 

  • Wu CH, Hsiao TY, Chen JC, Chang YC, Lee SY (1997) Evaluation of swallowing safety with fiberoptic endoscope: comparison with videofluoroscopic technique. Laryngoscope 107:396–401

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Neurologie mit Institut für Translationale Neurologie, Universitätsklinikum Münster, Münster, Deutschland

    Rainer Dziewas & Tobias Warnecke

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  1. Rainer Dziewas
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  2. Tobias Warnecke
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Editors and Affiliations

  1. Klinik für Neurologische Intensivmedizin und Frührehabilitation, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany

    Martin Groß

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Dziewas, R., Warnecke, T. (2020). Schlucken und Schluckstörungen. In: Groß, M. (eds) Neurologische Beatmungsmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59014-0_6

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  • DOI: https://doi.org/10.1007/978-3-662-59014-0_6

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  • Publisher Name: Springer, Berlin, Heidelberg

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