Chinese Journal of Emergency and Critical Care Nursing >
Summary of the best evidence for dysphagia rehabilitation training in ICU patients after extubation of orotracheal intubation
Objective To retrieve，evaluate，and summarize the best evidence for swallowing rehabilitation training in ICU patients with post-extubation dysphagia，providing a reference for clinical application. Methods To address the issues related to swallowing rehabilitation training for ICU patients with post-extubation dysphagia，we systematically searched the clinical decision-making systems，guideline websites，professional association websites，and databases for clinical decisions，guidelines，best practice，expert consensus，evidence summaries，systematic reviews，and original studies. The search period was from database inception to September 9，2024. Four evidence-based trained researchers independently conducted quality assessment of the literature and evidence extraction. Results A total of 20 studies were included，and 22 pieces of evidence were summarized across six dimensions：multidisciplinary teams for swallowing rehabilitation，training assessment，training measures，outcome evaluation，health education，and precautions. Conclusion The best evidence summarized in this study for swallowing rehabilitation training in ICU patients with post-extubation dysphagia demonstrates scientific rigor and practicality. In clinical practice，evidence should be applied selectively based on specific circumstances to improve patient outcomes and enhance the quality of care.
ZHENG Yanmin , HUANG Zexi , HUANG Yaruo , CUI Nianqi , MA Xueqin , SHA Ruiqin , LIU Yonggang , TIAN Ying . Summary of the best evidence for dysphagia rehabilitation training in ICU patients after extubation of orotracheal intubation[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025 , 6(4) : 487 -493 . DOI: 10.3761/j.issn.2096-7446.2025.04.019
| [1] | Rassameehiran S, Klomjit S, Mankongpaisarnrung C, et al. Postex-tubation dysphagia[J]. Proc(Bayl Univ Med Cent), 2015, 28(1):18-20. |
| [2] | McIntyre M, Doeltgen S, Dalton N, et al. Post-extubation dyspha-gia incidence in critically ill patients:a systematic review and meta-analysis[J]. Aust Crit Care, 2021, 34(1):67-75. |
| [3] | Christmas C. Swallowing disorders and aspiration in palliative care:assessment and strategies for management[EB/OL].(2024-01-17)[2024-04]. http://112.2.34.14:9095/contents/zh-Hans/swal-lowing-disorders-and-aspiration-in-palliative-care-assessment-and-strategies-for-management?search=post-extubation%20dysphagia%20rehabilitation&source=search_result&selectedTitle=2%7E150& usage_type=default&display_rank=2. |
| [4] | Wu CP, Xu YJ, Wang TG, et al. Effects of a swallowing and oral care intervention for patients following endotracheal extu-bation:a pre- and post-intervention study[J]. Crit Care, 2019, 23(1):350. |
| [5] | 黄晓霞, 唐佳迎, 郭芝廷, 等. 气管插管患者拔管后吞咽障碍研究热点的可视化分析[J]. 中华急危重症护理杂志, 2024, 5(2):181-187. |
| Huang XX, Tang JY, Guo ZT, et al. Visualization analysis of research hotpots on post-extubation dysphagia in patients with tracheal intubation[J]. Chin J Emerg Crit Care Nurs, 2024, 5(2):181-187. | |
| [6] | 朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成[J]. 护士进修杂志, 2017, 32(21):1991-1994. |
| Zhu Z, Hu Y, Xing WJ, et al. The composition of different types of evidence based problems[J]. J Nurses Train, 2017, 32(21):1991-1994. | |
| [7] | 朱政, 胡雁, 周英凤, 等. 推动证据向临床转化(五)证据临床转化研究中的文献质量评价[J]. 护士进修杂志, 2020, 35(11):996-1000. |
| Zhu Z, Hu Y, Zhou YF, et al. Promotion evidence to clinical transformation:evidence resource retrieval for the purpose of clinical transformation[J]. J Nurses Train, 2020, 35(11):996-1000. | |
| [8] | Cumpston M, Li T, Page MJ, et al. Updated guidance for tru-sted systematic reviews:a new edition of the Cochrane Hand-book for Systematic Reviews of Interventions[J]. Coch Dat Sys-tem Rev, 2019, 10(10):ED000142. |
| [9] | Brodsky MB, Mayfield EB, Gross RD. Clinical decision making in the ICU:dysphagia screening,assessment,and treatment[J]. Semin Speech Lang, 2019, 40(3):170-187. |
| [10] | Johal J. Post-extubation dysphagia:assessment and early de-tection[EB/OL].(2023)[2024-06-12]. https://ovidsp.dc2.ovid.com/ovid-new-b/ovidweb.cgi?&S=JGACFPHIMOEBGJIKIPJJCF-AFJOBLAA00&Link+Set=S.sh.43%7c14%7csl_190. |
| [11] | Hyzy RC. Extubation management in the adult intensive care unit[EB/OL].(2024-02-14)[2024-04-24]. http://112.2.34.14:9095/contents/extubation-management-in-the-adult-intensive-care-unit?search=%E6%8B%94%E7%AE%A1%E5%90%8E%E5%90%9E%E5%92%BD%E9%9A%9C%E7%A2%8D&source=Out%20of%20date%20-%20zh-Hans. |
| [12] | 王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11):964-967. |
| Wang CQ, Hu Y. JBI evidence pre-classification and evidence rank system(2014 Edition)[J]. J Nurses Train, 2015, 30(11):964-967. | |
| [13] | 胡碎钗, 王丹进, 陈洁, 等. ICU获得性吞咽障碍基于HACCP原则的康复方案的建立与应用[J]. 中华全科医学, 2023, 21(2):350-353. |
| Hu SC, Wang DJ, Chen J, et al. Establishment and application of a rehabilitation program based on the HACCP principles for ICU-acquired dysphagia[J]. Chin J Gen Pract, 2023, 21(2):350-353. | |
| [14] | Lembo AJ. Oropharyngeal dysphagia:clinical features,diagno-sis,and management[EB/OL].(2023-04-18)[2024-04-24]. http://112.2.34.14:9095/contents/zh-Hans/oropharyngeal-dyspha-giacli-nical-features-diagnosis-and-management?search=%E6%8B%94% E7%AE%A1%E5%90%8E%E5%90%9E%E5%92%BD%E9%9A%9C%E7%A2%8D&topicRef=1634&source=see_link. |
| [15] | 尹佳宁, 管晓敏, 贾登帅, 等. ICU机械通气患者撤机后呼吸肌训练的最佳证据总结[J]. 中华护理杂志, 2024, 59(1):33-41. |
| Yin JN, Guan XM, Jia DS, et al. Summary of best evidence of respiratory muscle training in patients with mechanical venti-lation after withdrawal[J]. Chin J Nurs, 2024, 59(1):33-41. | |
| [16] | Yang S, Park JW, Min K, et al. Clinical practice guidelines for oropharyngeal dysphagia[J]. Ann Rehabil Med, 2023, 47(Suppl 1):S1-S26. |
| [17] | 中国康复医学会吞咽障碍康复专业委员会, 窦祖林, 温红梅, 等. 中国吞咽障碍康复管理指南(2023版)[J]. 中华物理医学与康复杂志, 2023, 45(12):1057-1072. |
| Chinese Rehabilitation Medicine Association Swallowing Disor-ders Rehabilitation Professional Committee, Dou ZL, Wen HM, et al. Guidelines for Rehabilitation Management of Swallow-ing Disorders in China(2023 Edition)[J]. Chin J Phys Med Rehabil, 2023, 45(12):1057-1072. | |
| [18] | Likar R, Aroyo I, Bangert K, et al. Management of swallowing disorders in ICU patients:a multinational expert opinion[J]. J Crit Care, 2024,79:154447. |
| [19] | Umay E, Eyigor S, Demirag K, et al. Best practice recommenda-tions for dysphagia management in intensive care unit(ICU):a delphi study from multidisciplinary experts in Turkey[J]. Dy-sphagia, 2024, 39(2):241-254. |
| [20] | 中国康复医学会康复护理专业委员会. 吞咽障碍康复护理专家共识[J]. 护理学杂志, 2021, 36(15):1-4. |
| Rehabilitation Nursing Professional Committee of the Chinese Rehabilitation Medicine Association. Expert consensus on dys-phagia rehabilitation care[J]. J Nurs Sci, 2021, 36(15):1-4. | |
| [21] | Chen L, Liu C, Yuan MM, et al. Interventions for postextuba-tion dysphagia in critically ill patients:a systematic review and meta-analysis[J]. Dysphagia, 2024, 39(6):1013-1024. |
| [22] | Niu CY, Zhou WY, Wang HF, et al. The effect of voice train-ing interventions on patients with oropharyngeal dysphagia:a systematic review[J]. Eur Arch Otorhinolaryngol, 2023, 280(3):973-984. |
| [23] | Remijn L, Sanchez F, Heijnen BJ, et al. Effects of oral health interventions in people with oropharyngeal dysphagia:a systematic review[J]. J Clin Med, 2022, 11(12):3521. |
| [24] | Speyer R, Cordier R, Sutt AL, et al. Behavioural interventions in people with oropharyngeal dysphagia:a systematic review and meta-analysis of randomised clinical trials[J]. J Clin Med, 2022, 11(3):685. |
| [25] | Park JS, Hwang NK. Chin tuck against resistance exercise for dysphagia rehabilitation:a systematic review[J]. J Oral Rehabil, 2021, 48(8):968-977. |
| [26] | Siao SF, Ku SC, Tseng WH, et al. Effects of a swallowing and oral-care program on resuming oral feeding and reducing pneu-monia in patients following endotracheal extubation:a rando-mized,open-label,controlled trial[J]. Crit Care, 2023,27:283. |
| [27] | Lin R, Chen H, Chen L, et al. Effects of a spray-based oro-pharyngeal moisturising programme for patients following endotracheal extubation after cardiac surgery:a randomised,controlled three-arm trial[J]. Inter J Nurs Stud, 2022,130:104214. |
| [28] | 刘彩云, 王晓晶, 闫丽, 等. 护士主导的吞咽训练对拔管后吞咽障碍患者的影响[J]. 护理学杂志, 2023, 38(2):12-15. |
| Liu CY, Wang XJ, Yan L, et al. Effect of nurse-led swallowing training on patients with post-extubation dysphagia[J]. J Nurs Sci, 2023, 38(2):12-15. | |
| [29] | Vorona S, Sabatini U, Al-Maqbali S, et al. Inspiratory muscle rehabilitation in critically ill adults. A systematic review and meta-analysis[J]. Ann Am Thorac Soc, 2018, 15(6):735-744. |
| [30] | Maamar A, Parent V, Prudhomme E, et al. Fiberoptic endos-copic validation of a clinical screening test of swallowing function in critically ill patients performed within 24 h after extubation[J]. J Crit Care, 2022,72:154119. |
| [31] | Marvin S, Thibeault S, Ehlenbach WJ. Post-extubation dyspha-gia:does timing of evaluation matter?[J]. Dysphagia, 2019, 34(2):210-219. |
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