Affordable Access

Access to the full text

Awareness and Management of Dysphagia in Dutch Intensive Care Units: A Nationwide Survey

Authors
  • van Snippenburg, Wouter1
  • Kröner, Anke1
  • Flim, Marleen1
  • Hofhuis, José1
  • Buise, Marc2
  • Hemler, Raphael3
  • Spronk, Peter1
  • 1 Intensive Care Medicine, Gelre Hospitals, Location Apeldoorn, Albert Schweitzerlaan 31, Apeldoorn, 7334 DZ, The Netherlands , Apeldoorn (Netherlands)
  • 2 Intensive Care Medicine, Catharina Hospital, Michelangelolaan 2, Eindhoven, 5623 EJ, The Netherlands , Eindhoven (Netherlands)
  • 3 Gelre Hospitals, Department of Otorhinolaryngology, Location Apeldoorn, Albert Schweitzerlaan 31, Apeldoorn, 7334 DZ, The Netherlands , Apeldoorn (Netherlands)
Type
Published Article
Journal
Dysphagia
Publisher
Springer US
Publication Date
Aug 01, 2018
Volume
34
Issue
2
Pages
220–228
Identifiers
DOI: 10.1007/s00455-018-9930-7
Source
Springer Nature
Keywords
License
Yellow

Abstract

Dysphagia is a common problem in the intensive care unit (ICU), yet no national guidelines on dysphagia prevention, screening, and management exist. We performed a survey to learn which strategies are commonly being used in Dutch ICUs. A survey was developed based on current literature and experts’ opinions. It comprised questions regarding hospital and ICU characteristics, perceived prevalence and importance of dysphagia, screening strategies, modalities used to prevent aspiration, and interventions used to improve swallowing function. It was sent to all 90 non-pediatric ICUs in The Netherlands. 67 of 90 addressed ICUs (74%) replied to our survey. A median relevance score of 4 (IQR 4–5) out of 5 was given to the topic of dysphagia. In 22% and 45% of ICUs, patients were always screened for dysphagia after extubation or tracheotomy, respectively. The water swallow test was always part of the work-up in 88% of ICUs. Fiberoptic endoscopic evaluation of swallowing was used occasionally in 60% of ICUs, versus videofluoroscopic swallowing study in 25%. In 49% of ICUs, no standardized active rehabilitation protocol for dysphagia existed. In the remaining 51%, swallowing exercises were always part of standard rehabilitation, occasionally supplemented by electrical stimulation or surface-EMG biofeedback training in 6 and 10%, respectively. Most Dutch ICUs do not regularly screen for dysphagia and almost half do not seem to have a diagnostic, treatment, or rehabilitation protocol, despite recognizing it as a significant and relatively frequent problem in the ICU with potentially serious patient consequences.

Report this publication

Statistics

Seen <100 times