Abstract：
OBJECTIVE: This review evaluates the efficacy and safety of dysphagia interventions for patients with prolonged endotracheal intubation (⩾48 h) in critical care units.
METHODS: We systematically searched PubMed, Cochrane Library, Medline, Embase, OVID, CINAHL, Wanfang (China), CNKI (China), and ProQuest Dissertations for studies published up to December 31, 2023.
METHODS: Inclusion criteria encompassed randomized controlled trials (RCTs), quasi-randomized trials, and cohort studies comparing dysphagia rehabilitation - such as swallowing stimulation, swallowing and respiratory muscle exercise, and neuromuscular electrical stimulation - with standard care or no treatment. The primary outcomes assessed were dysphagia severity, time to resume oral intake, and incidence of aspiration and aspiration pneumonia.
METHODS: Detailed information on study design, setting, participant demographics, interventions, and outcomes was systematically extracted.
RESULTS: Our analysis included ten studies with a total of 1031 participants. The findings demonstrate a significant reduction in dysphagia severity, time to oral intake and the risk of aspiration pneumonia, and an improvement in quality of life among patients receiving swallowing therapy. However, no substantial difference was found in nutritional status. Limited data availability necessitated a descriptive presentation of outcomes like the risk of aspiration, ICU/hospital stay duration, pharyngeal/oral residue severity, and intervention-related adverse events.
CONCLUSIONS: The current evidence for the effectiveness of dysphagia interventions in critically ill patients with prolonged endotracheal intubation is limited. There is a pressing need for future research, particularly high-quality RCTs employing standardized outcome measures, to substantiate these findings.
METHODS: We systematically searched PubMed, Cochrane Library, Medline, Embase, OVID, CINAHL, Wanfang (China), CNKI (China), and ProQuest Dissertations for studies published up to December 31, 2023.
METHODS: Inclusion criteria encompassed randomized controlled trials (RCTs), quasi-randomized trials, and cohort studies comparing dysphagia rehabilitation - such as swallowing stimulation, swallowing and respiratory muscle exercise, and neuromuscular electrical stimulation - with standard care or no treatment. The primary outcomes assessed were dysphagia severity, time to resume oral intake, and incidence of aspiration and aspiration pneumonia.
METHODS: Detailed information on study design, setting, participant demographics, interventions, and outcomes was systematically extracted.
RESULTS: Our analysis included ten studies with a total of 1031 participants. The findings demonstrate a significant reduction in dysphagia severity, time to oral intake and the risk of aspiration pneumonia, and an improvement in quality of life among patients receiving swallowing therapy. However, no substantial difference was found in nutritional status. Limited data availability necessitated a descriptive presentation of outcomes like the risk of aspiration, ICU/hospital stay duration, pharyngeal/oral residue severity, and intervention-related adverse events.
CONCLUSIONS: The current evidence for the effectiveness of dysphagia interventions in critically ill patients with prolonged endotracheal intubation is limited. There is a pressing need for future research, particularly high-quality RCTs employing standardized outcome measures, to substantiate these findings.
摘要：
目的：这篇综述评估了重症监护病房中长时间气管插管（48h）的吞咽困难干预措施的有效性和安全性。
方法：我们系统地搜索了PubMed，科克伦图书馆,Medline,Embase,OVID,CINAHL,万方(中国),CNKI(中国),以及截至2023年12月31日发表的研究的ProQuest论文。
方法：纳入标准包括随机对照试验（RCT），准随机试验，和队列研究比较吞咽困难康复-如吞咽刺激，吞咽和呼吸肌锻炼，和神经肌肉电刺激-标准护理或不治疗。评估的主要结果是吞咽困难的严重程度，恢复口服摄入的时间，以及吸入性和吸入性肺炎的发病率。
方法：关于研究设计的详细信息，设置,参与者人口统计，干预措施，并系统地提取结果。
结果：我们的分析包括10项研究，共1031名参与者。研究结果表明，吞咽困难的严重程度显着降低，口服时间和吸入性肺炎的风险，接受吞咽治疗的患者的生活质量得到改善。然而,在营养状况方面没有发现实质性差异。有限的数据可用性需要对结果进行描述性呈现，如愿望风险，ICU/住院时间,咽/口腔残留物严重程度，和干预相关的不良事件。
结论：目前关于吞咽困难干预对气管插管时间延长的危重患者的有效性的证据有限。迫切需要未来的研究，特别是采用标准化结果测量的高质量RCT，来证实这些发现。
方法：我们系统地搜索了PubMed，科克伦图书馆,Medline,Embase,OVID,CINAHL,万方(中国),CNKI(中国),以及截至2023年12月31日发表的研究的ProQuest论文。
方法：纳入标准包括随机对照试验（RCT），准随机试验，和队列研究比较吞咽困难康复-如吞咽刺激，吞咽和呼吸肌锻炼，和神经肌肉电刺激-标准护理或不治疗。评估的主要结果是吞咽困难的严重程度，恢复口服摄入的时间，以及吸入性和吸入性肺炎的发病率。
方法：关于研究设计的详细信息，设置,参与者人口统计，干预措施，并系统地提取结果。
结果：我们的分析包括10项研究，共1031名参与者。研究结果表明，吞咽困难的严重程度显着降低，口服时间和吸入性肺炎的风险，接受吞咽治疗的患者的生活质量得到改善。然而,在营养状况方面没有发现实质性差异。有限的数据可用性需要对结果进行描述性呈现，如愿望风险，ICU/住院时间,咽/口腔残留物严重程度，和干预相关的不良事件。
结论：目前关于吞咽困难干预对气管插管时间延长的危重患者的有效性的证据有限。迫切需要未来的研究，特别是采用标准化结果测量的高质量RCT，来证实这些发现。
