title: Swallowing dysfunction after critical illness.
abstract: 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.
authors.affiliation: Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver. Electronic address: madison.macht@ucdenver.edu.
authors.forename: Madison
authors.initials: M
authors.lastname: Macht
authors.affiliation: Rehabilitation Therapy, University of Colorado Hospital, Aurora, CO.
authors.forename: S David
authors.initials: SD
authors.lastname: White
authors.affiliation: Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver.
authors.forename: Marc
authors.initials: M
authors.lastname: Moss
mesh_terms: D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000628:therapy*; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000379:methods; D008297:Male; D011379:Prognosis; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome