Abstract:

Objective To systematically analyze the nurse-led post-extubation dysphagia management program for tracheal intubation，and to provide a reference for the prevention and management of post-extubation dysphagia in patients with acute and critical illness. Methods According to the research specifications of scoping reviews，a systematic search was conducted in English databases including Cochrane Library，PubMed，Embase，Web of Science，and Chinese databases such as CNKI，Wanfang Data，and Chinese Biomedical Literature Database. The search period was from the establishment of the databases to January 31，2024. Relevant literature on the management of post-extubation dysphagia was selected and systematically reviewed. Results A total of 22 studies were included，of which 2 studies were related to the assessment and intervention of post-extubation dysphagia，14 studies related to the screening and assessment of post-extubation dysphagia，6 studies related to the prevention and intervention of post-extubation dysphagia. The prevalence rate of post-extubation dysphagia ranged from 3% to 54.2%，the timing of assessment was mostly started 2-24 h after extubation，and the tools used included Functional Oral Intake Scale，Repetitive Saliva Swallowing Test，etc. Some studies combined multiple tools for screening，and positive patients received 1 or 2 reassessments at 24 h before referral to rehabilitation or speech therapist. Prevention and intervention methods included oral exercises，compensatory strategies，ventilator strength training，health education，and cold spray therapy，with interventions mostly starting 24 h after extubation and continuing for at least 10 d or until discharge. Conclusion Nurse-led dysphagia management is feasible and safe，reduces the waiting time for oral feeding，decreases the risk of aspiration pneumonia，and compensates for the lack of resources for speech therapists in the ICU. However，there is a lack of standardized assessment and intervention protocols，and there is heterogeneity in the timing of assessment，assessment tools，and intervention protocols. High-quality clinical trials are needed to inform the development of comprehensive management strategies.

Key words: Tracheal Intubation, Post-extubation Dysphagia, Swallowing Assessment, Swallowing Rehabilita-tion, Scoping Review