Dysphagia screening tools after prolonged intubation: a systematic review of the literature

• Autor(a) principal: Azevedo, Paulo
• Data de Publicação: 2023
• Outros Autores: Saraiva, Manuel, Oliveira, Margarida, Oliveira, Isabel
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.33194/rper.2023.264
• topic: Perturbações da deglutição; cuidados intensivos; rastreio; intubação endotraqueal; cuidados de enfermagem; enfermagem em reabilitação; Swallowing disorders; critical care; screening; intratracheal intubation; nursing care; rehabilitation nursing; Trastornos de deglución; cuidados intensivos; cribado; intubación intratraqueal; atención de enfermería; enfermería en rehabilitación

Introduction: Post-extubation dysphagia affects a significant percentage of patients. However, its screening is not systematically performed, contributing to low awareness of the problem and predisposing to complications. The systematization of the approach to these patients begins with the use of reliable and sensitive screening tools. Methodology: Systematic literature review guided by the principles of the Cochrane Screening and Diagnostic Test Methods Group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The Medline, Cochrane Library, Scielo, Science Direct and CINAHL databases were consulted. Additionally, a gray literature search was performed. Inclusion criteria included validation studies of screening instruments for patients after prolonged intubation (more than 48 hours). Results: 7043 articles were reviewed of which seven were selected for full reading, and only one met the inclusion criteria. Discussion: There are several validated dysphagia screening instruments for other clinical populations, but only one was identified for this specific population. The instrument has good inter-rater reliability, however, a sensitivity of 81%, means that part of these patients will not be identified as dysphagic, which will have negative repercussions. This instrument was validated against clinical evaluation, which is a limitation to the interpretation of its results. Conclusion: There is no Portuguese version of this instrument, which hinders the development of guidelines that systematize the therapeutic approach for patients after extubation. We advocate its translation and validation for the national context and validation with a reference test.