Dysphagia in post-extubation respiratory failure: Potential implications of noninvasive ventilation

Abstract

Airway isolation by endotracheal intubation or tracheostomy impedes or even interrupts speech and swallowing. Pharyngeal and laryngeal impairment frequently occurs after extubation; the common consequences are dysphonia, dysphagia, and the aspiration of oral secretions, food, or fluids. Post-extubation dysphagia (PED) is an important entity pathologically that is frequently underestimated or even neglected. Although the implications of PED are major in neurologic patients, even in non-neurologic patients it is associated with poor prognosis and high risk of bronchial aspiration leading to pneumonia, with resultant prolongation of hospital stay and increased mortality. In this chapter, we review possible implications (advantages and disadvantages) of the use of noninvasive mechanical ventilation with regard to PED treatment.