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Swallowing Complications After Endotracheal Extubation: Moving From “Whether” to “How”

John E. Heffner, MD, FCCP
Author and Funding Information

From the Providence Portland Medical Center and Oregon Health and Science University.

Correspondence to: John E. Heffner, MD, FCCP, 5050 NE Hoyt St, Suite 540, Portland, OR 97213; e-mail: john_heffner@mac.com


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(3):509-510. doi:10.1378/chest.09-2477
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Normal swallowing depends on a complex sequence of perfectly timed physiologic events, some occurring simultaneously, others sequentially, that involve contractions of multiple oral-facial, pharyngeal, laryngeal, respiratory, and esophageal muscles.1 To prevent aspiration, a bolus of food or fluid reaching the posterior oral cavity stimulates neuroreceptors that trigger respiratory muscles to halt respiration, usually in exhalation.2 It is no surprise that an endotracheal tube might disturb these intricately choreographed events and cause postextubation dysphagia.

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