LAUSR

Despite having the tools and techniques for tracheal intubation for > 4000 years [1], and performing oral intubation with positive pressure mechanical ventilation for > 50 years [2], only recently has attention focused on patient issues following extubation, particularly swallowing-related complications. The endotracheal tube traverses the oropharynx, larynx, and trachea, with potential for laryngeal and tracheal injury, voice dysfunction, and dysphagia (i.e., swallowing dysfunction). Aspiration (i.e., one consequence of dysphagia) is present in ≥ 40% of medical-surgical and cardiac patients post-extubation [3–5]. When an instrumental evaluation of swallowing demonstrates dysphagia with aspiration, there are important clinical concerns regarding pneumonia [6], with implications for the intensive care unit (ICU) team and other clinicians, including speech-language pathologists/ therapists (SLPs/SLTs), otolaryngologists, gastroenterologists, pulmonologists, and radiologists. Unfortunately, there is great variability in screening and diagnosing dysphagia across ICUs and hospitals [7, 8]—creating a new frontier for research and quality improvement activities [9]. Herein, we discuss selected concerns regarding dysphagia in ICU patients post-extubation and outline opportunities for multidisciplinary management.