What is it about?

Keeping an endotracheal tube in for a long time can make it more difficult for patients to be able to eat by mouth after the tube is removed. It also increases the chances of aspiration. Because of this, speech-language pathologists (SLPs) should assess the swallow function after the breathing tube is removed.

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Why is it important?

These findings are important because they show that the longer a patient is on a breathing tube, the longer it will take for them to safely eat by mouth after the tube is removed. For example, patients who were intubated for 1–16 days were cleared to eat earlier those those who were intubated 17–34 days. Additionally, the study found that many patients had trouble swallowing safely, with 78% of those who had aspiration had no sensory response to aspiration. It’s crucial for speech-language pathologists to assess swallowing after extubation and instrumental swallow studies are helpful to assess as the risk of silent aspiration is higher when the patient is intubated for a longer length of time.

Perspectives

Elizabeth and I are both full time clinicians working in an acute care hospital and conducted this study during the pandemic where we felt there was an opportunity to look at the long length of time people had endotracheal tubes. Because of infection measures, tracheostomy tubes were placed much later in those who had COVID-19. We were seeing higher rates of dysphagia and silent aspiration after removal of endotracheal tubes than we previously saw with shorter lengths of intubation.

Renee Bricker
University of Virginia

Read the Original

This page is a summary of: Postextubation Dysphagia Among Patients With COVID-19: Results of Instrumental Swallow Studies and Clinical Swallow Evaluations, American Journal of Speech-Language Pathology, January 2025, American Speech-Language-Hearing Association (ASHA),
DOI: 10.1044/2024_ajslp-23-00442.
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