Interventions for oropharyngeal dysphagia in acute and critical care: a systematic review and meta-analysis.

Intensive Care Medicine
Sallyanne DuncanBronagh Blackwood

Abstract

To determine the effectiveness of dysphagia interventions compared to standard care in improving oral intake and reducing aspiration for adults in acute and critical care. We searched electronic literature for randomised and quasi-randomised trials and bibliography lists of included studies to March 2020. Study screening, data extraction, risk of bias and quality assessments were conducted independently by two reviewers. Meta-analysis used fixed effects modelling. The systematic review protocol is registered and published. We identified 22 studies (19 stroke, 2 intensive care stroke and 1 general intensive care) testing 9 interventions and representing 1700 patients. Swallowing treatment showed no evidence of a difference in the time to return to oral intake (n = 33, MD (days) - 4.5, 95% CI - 10.6 to 1.6, 1 study, P = 0.15) (very low certainty) or in aspiration following treatment (n = 113, RR 0.79, 95% CI 0.44 to 1.45, 4 studies, I2 = 0%, P = 0.45) (low certainty). Swallowing treatment showed evidence of a reduced risk of pneumonia (n = 719, RR 0.71, 95% CI 0.56 to 0.89, 8 studies, I2 = 15%, P = 0.004) (low certainty) but no evidence of a difference in swallowing quality of life scores (n = 239, MD - 11.38, 95% CI - 23.83 to 1...Continue Reading

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Citations

Jul 23, 2020·Intensive Care Medicine·Patrick ZuercherJoerg C Schefold
Feb 16, 2021·The Journal of Clinical Investigation·Michael Camilleri
Apr 7, 2021·The Journal of Thoracic and Cardiovascular Surgery·Robert B Cameron
Apr 28, 2021·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·N A ClaytonP K Maitz
Jul 24, 2021·Medicina intensiva·L Santana-CabreraJ C Martín González
Oct 2, 2021·PM & R : the Journal of Injury, Function, and Rehabilitation·Nicole Langton-Frost, Martin B Brodsky

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