Post-extubation dysphagia and speech-language and motor rehabilitation in critically ill patients: A narrative review
DOI:
https://doi.org/10.62827/fb.v27i8.1283Keywords:
Deglutition Disorders; Intensive Care Units; Speech Therapy; Exercise Therapy; Respiration.Abstract
Introduction: Post-extubation dysphagia is common in critically ill patients and may delay oral intake, promote aspiration, and worsen outcomes. Objective: To analyze the occurrence, associated factors, recognition methods, and evidence on speech-language and motor rehabilitation for post-extubation dysphagia in critically ill adults. Methods: A narrative review was conducted through searches in August 2026 in PubMed, the Scientific Electronic Library Online, and the Cochrane Library, complemented by reference tracking. Studies published from 2021 to 2026 on adults undergoing orotracheal intubation, early recognition, and rehabilitation were prioritized. Twenty-three publications comprised the synthesis, with study designs appraised according to the questions they could answer. Results: The most recent pooled estimate was 35% (95% CI: 25–46%), whereas an earlier synthesis found 41%; differences in population, timing, and assessment methods preclude direct comparison. Silent aspiration and the incomplete accuracy of bedside examination supported structured screening, speech-language assessment, and selective instrumental investigation. Speech-language interventions showed favorable results for oral intake and pneumonia, but protocols were heterogeneous and samples were small. Motor rehabilitation supported systemic conditions for eating, although evidence of a direct effect on swallowing remained scarce. Conclusion: The synthesized literature indicates that clinical readiness, screening, specialized assessment, and interdisciplinary rehabilitation may guide safe progression of oral intake. Intubation duration increases suspicion but does not confirm dysphagia; care requires serial reassessment. Therapeutic evidence remains limited and heterogeneous.
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Copyright (c) 2026 Rafael Viana dos Santos Coutinho, Mônica Ferreira da Silva, Júlia Manfré Moraes Dutra, Victor Augusto Sebben, Igor Parada Marangoni (Autor)
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