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Dysphagia in Intensive Care Evaluation (DICE): An International Cross-Sectional Survey

2022; Springer Science+Business Media; Volume: 37; Issue: 6 Linguagem: Inglês

10.1007/s00455-021-10389-y

1432-0460

Peter E. Spronk, Laura E. J. Spronk, Ingrid Egerod, Jennifer McGaughey, Jackie McRae, Louise Rose, Martin B. Brodsky, Martin B. Brodsky, Louise Rose, Jonneke Lut, Père Clavé, Rahul Nanchal, Yoko Inamoto, J. I. van der Hoeven, Peter E. Spronk, Amy Freeman‐Sanderson, M. Hiesmayr, Cécilia Veraar, Cheryl Hickmann, Rik Gosselink, S Gershman, Stacey A. Skoretz, Rosemary Martino, Meropi Mpouzika, Michal Černý, Viktor Chrobok, Lucie Zeinerová, Ingrid Egerod, Gudrun Kaldan, Jackie McRae, Michael Backlund, TARSILA DE CARVALHO FREITAS RAMOS, Peter Nydahl, Maria Kalafati, Thomasin Andrews, Riccardo Sperlinga, Hideo Katsukawa, Fumihito Kasai, Laura E. J. Spronk, Anna Miles, Jennifer McGaughey, Sallyanne Duncan, Magdalena Fossum, V. Ágústdóttir, T. Senneset, Matz Larsson, GREME M. HAMMOND, Radosław Owczuk, Sandrine Mestre, Judith L. Merriweather, Miroslav Tedla, Žofia Frajková, Mercedes Velasco, Eva Åkerman, A Sibilla, Berit Kertscher, B. Gaechter, Selen Serel Arslan, Numan Demır, Gemma Jones,

Esophageal and GI Pathology

Dysphagia occurs commonly in the intensive care unit (ICU). Despite the clinical relevance, there is little worldwide research on prevention, assessment, evaluation, and/or treatment of dysphagia for ICU patients. We aimed to gain insight into this international knowledge gap. We conducted a multi-center, international online cross-sectional survey of adult ICUs. Local survey distribution champions were recruited through professional and personal networks. The survey was administered from November 2017 to June 2019 with three emails and a final telephone reminder. Responses were received from 746 ICUs (26 countries). In patients intubated > 48 h, 17% expected a > 50% chance that dysphagia would develop. This proportion increased to 43% in patients intubated > 7 days, and to 52% in tracheotomized patients. Speech-language pathologist (SLP) consultation was available in 66% of ICUs, only 4% reported a dedicated SLP. Although 66% considered a routine post-extubation dysphagia protocol important, most (67%) did not have a protocol. Few ICUs routinely assessed for dysphagia after 48 h of intubation (30%) or tracheostomy (41%). A large proportion (46%) used water swallow screening tests to determine aspiration, few (8%) used instrumental assessments (i.e., flexible endoscopic evaluation of swallowing). Swallowing exercises were used for dysphagia management by 30% of ICUs. There seems to be limited awareness among ICU practitioners that patients are at risk of dysphagia, particularly as ventilation persists, protocols, routine assessment, and instrumental assessments are generally not used. We recommend the development of a research agenda to increase the quality of evidence and ameliorate the implementation of evidence-based dysphagia protocols by dedicated SLPs.