Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study
Yıl: 2022 Cilt: 20 Sayı: 3 Sayfa Aralığı: 154 - 160 Metin Dili: İngilizce DOI: 10.4274/tybd.galenos.2021.71473 İndeks Tarihi: 07-10-2022
Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study
Öz: Objective: This study aimed to investigate the current dysphagia practices and their defined awareness in the intensive care units (ICUs) in Turkey. Materials and Methods:The study was part of an international, multi-center survey, called Dysphagia in Intensive Care Evaluation. The survey included questions related to the descriptive information and questions under three subgroups, including current practice, awareness, and perceived best practice, and was sent to ICU department managers via Google forms for them to answer on behalf of their ICU. Results: A total of 39 responses were received, which revealed no standard protocol in all ICUs that indicates which patients should be screened for dysphagia. Cough reflex testing and water swallow tests were the most common methods to confirm dysphagia. Oral hygiene, postural adjustments, modifications, and delay feeding and retry the next day were reported as the most common preventions for aspiration, and repetitive swallowing exercises/maneuvers, muscle strengthening exercises, and respiratory exercises were most common for dysphagia treatment. The awareness- related survey items revealed a mean score of >5 on a 7-level Likert scale. Conclusion: Dysphagia practice in the ICUs in Turkey needs improvement, with established standardized management protocol.
Anahtar Kelime: Türkiye’de Yoğun Bakım Ünitelerinde Disfaji: Kesitsel Bir Anket Çalışması
Öz: Amaç: Bu çalışma, Türkiye’deki yoğun bakım ünitelerinde (YBÜ) mevcut disfaji uygulamalarını araştırmış ve disfajiye ilişkin farkındalığı tanımlamıştır. Gereç ve Yöntem: Çalışma, Yoğun Bakım Değerlendirmesinde Disfaji (YBDD) adı verilen uluslararası, çok merkezli bir anket çalışmasının bir parçasıdır. Anket, açıklayıcı bilgilerle ilgili soruları ve mevcut uygulama, farkındalık ve algılanan en iyi uygulamayı içeren üç alt grup altındaki soruları içermektedir. Anket, yoğun bakım departmanı yöneticilerine YBÜ’ler adına yanıtlamaları için Google formları aracılığıyla gönderildi. Bulgular: Toplam 39 yanıt alındı. YBÜ’lerin hiçbirinde, hangi hastaların disfaji için taranması gerektiğini belirten standart bir protokol yoktu. Öksürük refleksi testi ve su yutma testi, disfajiyi doğrulamak için kullanılan en yaygın yöntemlerdendi. Ağız hijyeni, postür ayarlamaları, modifikasyonlar ve beslemeyi geciktirme ve ertesi gün yeniden deneme aspirasyon için en yaygın kullanılan önlemler olarak rapor edildi ve tekrarlayan yutma egzersizleri/manevraları, kas güçlendirme egzersizleri ve solunum egzersizleri disfajiyi tedavi etmek için en yaygın kullanılan müdahalelerdi. Farkındalıkla ilgili anket maddelerinden alınan ortalama puan 7 seviyeli Likert ölçeğinde 5’in üzerindeydi. Sonuç: Türkiye’de YBÜ’lerde disfaji uygulamasının iyileştirilmesi ve standart bir yönetim protokolü oluşturulması gerekmektedir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Lancaster J. Dysphagia: its nature, assessment and management. Br J Community Nurs 2015;Suppl Nutrition:S28-32.
- 2. Philpott H, Garg M, Tomic D, Balasubramanian S, Sweis R. Dysphagia: Thinking outside the box. World J Gastroenterol 2017;23:6942-51.
- 3. Arvedson JC. Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches. Dev Disabil Res Rev 2008;14:118-27.
- 4. White GN, O'Rourke F, Ong BS, Cordato DJ, Chan DK. Dysphagia: causes, assessment, treatment, and management. Geriatrics 2008;63:15-20.
- 5. Ekberg O. Dysphagia: Diagnosis and treatment. Springer; New York. 2012.
- 6. Palli C, Fandler S, Doppelhofer K, Niederkorn K, Enzinger C, Vetta C, et al. Early Dysphagia Screening by Trained Nurses Reduces Pneumonia Rate in Stroke Patients: A Clinical Intervention Study. Stroke 2017;48:2583-5.
- 7. Guillen-Sola A, Soler NB, Marco E, Pera-Cegarra O, Foro P. Effects of prophylactic swallowing exercises on dysphagia and quality of life in patients with head and neck cancer receiving (chemo) radiotherapy: the Redyor study, a protocol for a randomized clinical trial. Trials 2019;20:503.
- 8. Sørensen RT, Rasmussen RS, Overgaard K, Lerche A, Johansen AM, Lindhardt T. Dysphagia screening and intensified oral hygiene reduce pneumonia after stroke. J Neurosci Nurs 2013;45:139-46.
- 9. Marin S, Serra-Prat M, Ortega O, Clavé P. Healthcare-related cost of oropharyngeal dysphagia and its complications pneumonia and malnutrition after stroke: a systematic review. BMJ Open 2020;10:e031629.
- 10. Skoretz SA, Flowers HL, Martino R. The incidence of dysphagia following endotracheal intubation: a systematic review. Chest 2010;137:665-73.
- 11. Zuercher P, Moret CS, Dziewas R, Schefold JC. Dysphagia in the intensive care unit: epidemiology, mechanisms, and clinical management. Crit Care 2019;23:103.
- 12. Perren A, Zürcher P, Schefold JC. Clinical Approaches to Assess Post-extubation Dysphagia (PED) in the Critically Ill. Dysphagia 2019;34:475-86.
- 13. Macht M, Wimbish T, Clark BJ, Benson AB, Burnham EL, Williams A, et al. Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. Crit Care 2011;15:R231.
- 14. Zuercher P, Dziewas R, Schefold JC. Dysphagia in the intensive care unit: a (multidisciplinary) call to action. Intensive Care Med 2020;46:554-6.
- 15. van Snippenburg W, Kröner A, Flim M, Hofhuis J, Buise M, Hemler R, et al. Awareness and Management of Dysphagia in Dutch Intensive Care Units: A Nationwide Survey. Dysphagia 2019;34:220-8.
- 16. Macht M, Wimbish T, Clark BJ, Benson AB, Burnham EL, Williams A, et al. Diagnosis and treatment of post- extubation dysphagia: results from a national survey. J Crit Care 2012;27:578- 86.
- 17. Zuercher P, Moret C, Schefold JC. Dysphagia in the intensive care unit in Switzerland (DICE) - results of a national survey on the current standard of care. Swiss Med Wkly 2019;149:w20111.
- 18. Zuercher P, Schenk NV, Moret C, Berger D, Abegglen R, Schefold JC. Risk Factors for Dysphagia in ICU Patients After Invasive Mechanical Ventilation. Chest 2020;158:1983-91.
- 19. Medeiros GC, Sassi FC, Mangilli LD, Zilberstein B, Andrade CR. Clinical dysphagia risk predictors after prolonged orotracheal intubation. Clinics (Sao Paulo) 2014;69:8-14.
- 20. DePippo KL, Holas MA, Reding MJ. Validation of the 3-oz water swallow test for aspiration following stroke. Arch Neurol 1992;49:1259-61.
- 21. Wu MC, Chang YC, Wang TG, Lin LC. Evaluating swallowing dysfunction using a 100-ml water swallowing test. Dysphagia 2004;19:43-7.
- 22. Macht M, White SD, Moss M. Swallowing dysfunction after critical illness. Chest 2014;146:1681-9.
- 23. Marian T, Dünser M, Citerio G, Koköfer A, Dziewas R. Are intensive care physicians aware of dysphagia? The MADICU survey results. Intensive Care Med 2018;44:973-5.
- 24. McIntyre M, Doeltgen S, Dalton N, Koppa M, Chimunda T. Post-extubation dysphagia incidence in critically ill patients: A systematic review and meta- analysis. Aust Crit Care 2021;34:67-75.
- 25. Skoretz SA, Riopelle SJ, Wellman L, Dawson C. Investigating Swallowing and Tracheostomy Following Critical Illness: A Scoping Review. Crit Care Med 2020;48:e141-51.
- 26. Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 2019;38:48-79.
| APA | SEREL ARSLAN S, DEMIR N (2022). Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study. , 154 - 160. 10.4274/tybd.galenos.2021.71473 |
| Chicago | SEREL ARSLAN SELEN,DEMIR NUMAN Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study. (2022): 154 - 160. 10.4274/tybd.galenos.2021.71473 |
| MLA | SEREL ARSLAN SELEN,DEMIR NUMAN Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study. , 2022, ss.154 - 160. 10.4274/tybd.galenos.2021.71473 |
| AMA | SEREL ARSLAN S,DEMIR N Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study. . 2022; 154 - 160. 10.4274/tybd.galenos.2021.71473 |
| Vancouver | SEREL ARSLAN S,DEMIR N Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study. . 2022; 154 - 160. 10.4274/tybd.galenos.2021.71473 |
| IEEE | SEREL ARSLAN S,DEMIR N "Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study." , ss.154 - 160, 2022. 10.4274/tybd.galenos.2021.71473 |
| ISNAD | SEREL ARSLAN, SELEN - DEMIR, NUMAN. "Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study". (2022), 154-160. https://doi.org/10.4274/tybd.galenos.2021.71473 |
| APA | SEREL ARSLAN S, DEMIR N (2022). Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study. Türk Yoğun Bakım Dergisi, 20(3), 154 - 160. 10.4274/tybd.galenos.2021.71473 |
| Chicago | SEREL ARSLAN SELEN,DEMIR NUMAN Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study. Türk Yoğun Bakım Dergisi 20, no.3 (2022): 154 - 160. 10.4274/tybd.galenos.2021.71473 |
| MLA | SEREL ARSLAN SELEN,DEMIR NUMAN Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study. Türk Yoğun Bakım Dergisi, vol.20, no.3, 2022, ss.154 - 160. 10.4274/tybd.galenos.2021.71473 |
| AMA | SEREL ARSLAN S,DEMIR N Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study. Türk Yoğun Bakım Dergisi. 2022; 20(3): 154 - 160. 10.4274/tybd.galenos.2021.71473 |
| Vancouver | SEREL ARSLAN S,DEMIR N Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study. Türk Yoğun Bakım Dergisi. 2022; 20(3): 154 - 160. 10.4274/tybd.galenos.2021.71473 |
| IEEE | SEREL ARSLAN S,DEMIR N "Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study." Türk Yoğun Bakım Dergisi, 20, ss.154 - 160, 2022. 10.4274/tybd.galenos.2021.71473 |
| ISNAD | SEREL ARSLAN, SELEN - DEMIR, NUMAN. "Dysphagia in the Intensive Care Units in Turkey: A Cross-sectional Survey Study". Türk Yoğun Bakım Dergisi 20/3 (2022), 154-160. https://doi.org/10.4274/tybd.galenos.2021.71473 |
