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J Caring Sci. 2023;12(4): 213-220.
doi: 10.34172/jcs.2023.33005
PMID: 38250001
PMCID: PMC10799270
  Abstract View: 442
  PDF Download: 452

Original Article

Effectiveness of Swallowing and Oral Care Interventions on Oral Intake and Salivary Flow of Patients Following Endotracheal Extubation at a Tertiary Care Center: A Randomized Controlled Trial

Sherill Ann Chacko 1 ORCID logo, Lakshmi Ramamoorthy 1* ORCID logo, Anusha Cherian 1 ORCID logo, R Anusuya 2 ORCID logo, HT Lalthanthuami 1 ORCID logo, Rani Subramaniyan 1 ORCID logo

1 College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
2 Department of Anaesthesiology and Critical Care, JIPMER, Pondicherry, India
*Corresponding Author: Lakshmi Ramamoorthy, Email: laxmi_ramamoorthy@yahoo.com

Abstract

Introduction: Endotracheal intubation and mechanical ventilation are the most frequently used life-sustaining interventions in critical care. Prolonged intubation can lead to post-extubation dysphagia, affecting the individual’s nutritional level and communication ability. Thereupon, this study aims to assess the effectiveness of swallowing and oral care interventions in resuming oral intake and increasing salivary flow in post-extubation patients.

Methods: A randomized controlled trial was conducted in critical care units of a tertiary care setting, where 92 post-extubation patients who had undergone intubation for≥48 hours were enrolled. The intervention group received swallowing and oral interventions, including safe swallowing education (SSE), toothbrushing, salivary gland massage, oral cavity, and swallowing exercises. In contrast, the control group received standard oral care every 8th hour. Oral intake was assessed daily with the Functional Oral Intake Scale, and the salivary flow measurement was assessed with oral Schirmer’s test on the 1st, 3rd, and 7th day after extubation.

Results: The baseline demographic and clinical characteristics showed that the groups were homogenous. The intervention group achieved total oral intake two days earlier than the control group. Findings also showed that the participants in the intervention group had a significant increase in salivary flow than in the control group on the 3rd and 7th days of the intervention.

Conclusion: Swallowing and oral care interventions help post-extubation patients resume early oral intake and increase salivary flow after prolonged intubation. Hence, it improves the patient’s outcome toward a healthy life.

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Submitted: 19 Apr 2023
Accepted: 26 Aug 2023
ePublished: 12 Nov 2023
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