Safety-related outcomes for patients with a tracheostomy and the use of flexible endoscopic evaluation of swallowing (FEES) for assessment and management of swallowing: A systematic review.

IF 1.4 4区 医学 Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY International Journal of Speech-Language Pathology Pub Date : 2024-03-10 DOI:10.1080/17549507.2023.2293633
Katherine Morris, Nicholas F Taylor, Amy Freeman-Sanderson
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Abstract

Purpose: The purpose of this systematic review was to examine safety-related outcomes for patients with tracheostomy after flexible endoscopic evaluation of swallowing (FEES) to assess and manage their swallow, when compared to other non-instrumental swallow assessments such as clinical swallowing examination (CSE) and/or a modified Evans blue dye test (MEBDT).

Method: Three databases were searched for articles referring to safety-related outcome data for adults with a tracheostomy, who underwent FEES and CSE and/or MEBDT. Articles were screened using predefined inclusion/exclusion criteria.

Result: The search strategy identified 2097 articles; following abstract and full-text screening, seven were included for review. The summary of evidence found low to very low certainty that FEES was associated with improved outcomes across swallow safety, physiological outcomes, tracheostomy cannulation duration, functional outcomes, and detection of upper airway pathologies.

Conclusion: This systematic review demonstrated low to very low certainty evidence from seven heterogeneous studies with low sample sizes that incorporating FEES may be associated with improved safety-related outcomes. There is less evidence supporting the accuracy of other swallow assessments conducted at the point of care (i.e. CSE and MEBDT). Future research requires studies with larger sample sizes and routine reporting of safety-related outcomes with use of FEES.

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气管造口术患者的安全相关结果以及使用柔性内窥镜吞咽评估(FEES)进行吞咽评估和管理:系统综述。
目的:本系统性综述的目的是研究气管造口术患者在接受柔性内窥镜吞咽评估(FEES)以评估和管理其吞咽情况后,与其他非仪器吞咽评估(如临床吞咽检查(CSE)和/或改良伊文思蓝染色试验(MEBDT))相比的安全相关结果:在三个数据库中搜索了与气管造口术成人安全相关的结果数据的文章,这些成人接受了 FEES 和 CSE 和/或 MEBDT。采用预定义的纳入/排除标准对文章进行筛选:搜索策略共发现了 2097 篇文章;经过摘要和全文筛选,共纳入 7 篇文章进行审查。证据摘要发现,在吞咽安全、生理结果、气管插管持续时间、功能结果和上气道病变检测等方面,FEES 与改善结果相关的确定性较低到非常低:本系统综述从七项样本量较低的异质性研究中获得了低度到极低度确定性的证据,表明采用 FEES 可能与安全性相关结果的改善有关。支持在护理点进行的其他吞咽评估(即 CSE 和 MEBDT)准确性的证据较少。未来的研究需要进行样本量更大的研究,并对使用 FEES 的安全相关结果进行常规报告。
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来源期刊
International Journal of Speech-Language Pathology
International Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION
CiteScore
3.10
自引率
16.70%
发文量
73
审稿时长
>12 weeks
期刊介绍: International Journal of Speech-Language Pathology is an international journal which promotes discussion on a broad range of current clinical and theoretical issues. Submissions may include experimental, review and theoretical discussion papers, with studies from either quantitative and/or qualitative frameworks. Articles may relate to any area of child or adult communication or dysphagia, furthering knowledge on issues related to etiology, assessment, diagnosis, intervention, or theoretical frameworks. Articles can be accompanied by supplementary audio and video files that will be uploaded to the journal’s website. Special issues on contemporary topics are published at least once a year. A scientific forum is included in many issues, where a topic is debated by invited international experts.
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