Prevalence and Management of Oral Intake Restrictions in Critically Ill Patients: Insights from a Multicenter Point Prevalence Study.
Takashi Hongo, Tetsuya Yumoto, Keibun Liu and 6 others
PMID 39433566WHAT IT FOUND
Most eligible ICU patients could not eat safely, yet half were never screened for swallowing problems.
Nurses did most checks and treatments, with no dedicated speech therapists in any unit. Post-stroke patients were screened far less often than others.
Key findings
01Among patients eligible for oral intake, 69.0% had restrictions due to swallowing issues, with only 31.0% able to eat a normal diet.
02Swallowing screening was performed in just 52.4% of eligible patients, and instrumental assessment like VFSS or FEES occurred in only 1.0% of cases.
03None of the 21 participating ICUs had a dedicated speech-language therapist, and 85.7% lacked a specific protocol for swallowing rehabilitation.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study could not clearly distinguish oral intake restrictions caused by dysphagia from those caused by other factors like medication effects, delirium, or gastrointestinal symptoms. As a point prevalence study, it captures only a single moment in time and cannot track changes in swallowing function or the long-term impact of interventions. Data was collected via self-report by unit representatives, which may introduce bias or inaccuracies regarding the actual frequency of screening and treatment. The survey may underestimate dysphagia in patients who were not screened, as 5.6% of unscreened patients had suspected dysphagia based on clinical symptoms.
Declared interests
The study was funded by Okayama University. The authors declared no other conflicts of interest.
The easy way to misread this
Do not assume that the high prevalence of oral intake restrictions proves that these patients have primary swallowing disorders. The study authors note they could not rigorously distinguish dysphagia from restrictions caused by other medical reasons like sedation, delirium, or gastrointestinal issues.