Pre-emptive swallowing stimulation in long-term intubated patients

Objective: To evaluate the effect of pre-emptive swallowing stimulation on the recovery of swallowing function in long-term intubated patients. Design and Subjects: Patients in the intensive care unit intubated for at least 48 hours due to respiratory distress from March to August 2004 were randomly divided into two groups. Fifteen patients of mean age 55.3 +/- 17.9 years were stimulated (experimental group) and 18 patients of mean age 61.3 +/- 13.5 years were not stimulated (control group). The duration of intubation was 15.5 +/- 6.7 days in the experimental group and 15.7 +/- 6.5 days in the control group. Duration of stimulation in the experimental group was 7.3 +/-3.6 days. After extubation, we compared the severity of dysphagia via video-fluoroscopic swallow study. Results: There were no statistically significant differences in the percentage of aspiration and the swallowed volume between the two groups. However, oral transit time in the experimental group (0.37 +/- 0.07 seconds) was significantly shorter than that of the control group (0.83 +/- 0.10 seconds), and the oropharyngeal swallowing efficiency of the experimental group (73.3 +/- 17.4%/s) was significantly higher than that of the control group (50.1 +/- 13.0%/s). Conclusion: Pre-emptive swallowing stimulation during intubation assists in the recovery of swallowing function in long-term intubated patients.