장기간의 기관 내 삽관 환자에 대한 발관 전 연하 자극

Abstract

Objective: To evaluate the effect of preemptive swallowing stimulation on the recovery of swallowing function in long-term intubated patients. Method: Patients in the intensive care unit intubated for at least 48 hours due to respiratory distress from March to August 2003 were randomly assigned to two groups. Fifteen patients were stimulated (experimental group), and 18 patients were not stimulated (control group). The duration of intubation was 15.5±6.7 days in the experimental group and 15.7±6.5 days in the control group. Duration of stimulation in the experimental group was 7.3±3.6 days. After extubation, we compared the severity of dysphagia via video-fluoroscopic swallowing study. Results: There was no difference in percentage of aspiration and swallowed volume between two groups. Oral transit time of the experimental group (0.37±0.07 sec) was significantly shorter than that of the control group (0.83±0.10 sec), and the oropharyngeal swallowing efficiency of the experimental group (73.3±17.4%/sec) was significantly higher than that of the control group (50.1±13.0%/sec). Conclusion: Preemptive swallowing stimulation in long term intubated patients may facilitate recovery of dysphagia.