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Evaluation of swallowing in the critically ill patient. The right time

International Physical Medicine & Rehabilitation Journal
Luisa Cecilia Ramirez Barraza, Anallely Vázquez Mijangos, Miguel Alejandro Fernandez Chavez, Jose Benito Parra Maldonado, Melissa Correa Flores

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Swallowing is defined as the passage of liquid and solid substances from the mouth to the stomach, and, within this process, there are four stages (anticipatory, oral, pharyngeal and esophageal) that will be responsible for carrying out said activity safely and effectively. If there is any alteration in any of these stages, it is called dysphagia, and consequently, the patient could present bronchial aspiration, malnutrition and dehydration; likewise, prolong the days of hospital stay and increase morbidity and mortality. The patient admitted to the Intensive Care Unit (ICU), may require mechanical ventilation support through an oro-tracheal tube or tracheostomy, which affects the structures involved in the act of swallowing (rigidity, weakness, alteration in subglottic pressure, sensitivity and edema) and its interaction with breathing, triggering a possible dysphagia associated with mechanical ventilation (VAMD). This involvement can occur at the time of extubation of the patient (post-extubation dysphagia) or if the patient has a tracheostomy cannula.


anticipatory, oral, pharyngeal , esophageal, dysphagia