Persistent Features of Laryngeal Injury Following Endotracheal Intubation: A Systematic Review.
Eileen Kelly, Julia Hirschwald, Julie Clemens and 1 others
PMID 36774422WHAT IT FOUND
After ICU intubation, many patients still have voice and swallowing problems weeks later.
This review found persistent issues in 23–33% of survivors, but the evidence is weak because studies used different tests and relied heavily on patient reports rather than scans.
Key findings
01Persistent voice and swallowing problems were reported in a substantial minority of patients after hospital discharge, with dysphagia affecting 23–33% and dysphonia 13.2–60%.
02The strength of the evidence is low because included studies used inconsistent assessment methods, often relying on patient-reported outcomes rather than instrumental evaluation.
03Factors like tracheostomy presence and ICU stay length were associated with swallowing and voice issues, but statistical analysis of these factors was not possible due to data variability.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The included studies used vastly different methods to assess voice and swallowing, making it hard to compare results. Most data on prevalence came from patient-reported questionnaires rather than objective instrumental tests like FEES or laryngoscopy. The review could not perform a meta-analysis or statistical pooling of risk factors due to missing data and heterogeneity. Only English-language studies were included, and grey literature was excluded. The timepoint for 'persistent' injury varied between studies, ranging from 8 weeks to over 4 years post-discharge.
Declared interests
The study was funded by the University of Dublin, Trinity College. The authors declared no other conflicts of interest.
The easy way to misread this
Do not interpret the wide ranges in prevalence (e.g., dysphonia 13.2–60%) as evidence that some populations are more affected than others. These ranges reflect the inconsistency in how the six included studies measured outcomes, not necessarily true differences in patient injury.