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Contemporary Reviews in Critical Care Medicine |

Swallowing Dysfunction After Critical IllnessSwallowing Dysfunction After Critical Illness

Madison Macht, MD; S. David White, CCC-SLP; Marc Moss, MD
Author and Funding Information

From the Division of Pulmonary Sciences and Critical Care Medicine (Drs Macht and Moss), University of Colorado Denver; and Rehabilitation Therapy (Mr White), University of Colorado Hospital, Aurora, CO.

CORRESPONDENCE TO: Madison Macht, MD, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver, AMC, RC2, C-272, 12700 E 19th Ave, Aurora, CO 80045; e-mail: madison.macht@ucdenver.edu


FUNDING/SUPPORT: Dr Moss was supported by National Institutes of Health [Grant NIH K24 HL089223: Enhancing patient-oriented research in acute lung injury].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(6):1681-1689. doi:10.1378/chest.14-1133
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Critical care practitioners must frequently make decisions about their patients’ ability to swallow food, liquids, and pills. These decisions can be particularly difficult given the incompletely defined epidemiology, diagnostic criteria, and prognostic features of swallowing disorders in critically ill patients. Furthermore, the consequences of improper decisions—namely, aspiration, malnutrition, hunger, and thirst—can be devastating to patients and their families. This review outlines the problem of swallowing dysfunction in critically ill patients and then addresses the most clinically relevant questions that critical care practitioners face today. First, we review the epidemiology of swallowing dysfunction in critically ill patients. Next, we describe the different diagnostic tests for swallowing dysfunction and describe a general approach to the initial assessment for swallowing disorders. Finally, we explore the existing treatments for swallowing dysfunction. Given the burden of swallowing dysfunction in patients recovering from critical illness, enabling critical care practitioners to manage these disorders, while stimulating new investigation into their pathophysiology, diagnosis, and management, will enhance our care of critically ill patients.

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