The incidence and risk factors of post-extubation dysphagia in critically ill surgical patients: protocol for prospective observational study


  • Natsuda Phothikun Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Poungkaew Thitisakulchai Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Phakamas Tanvijit Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Thassayu Yuyen Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand



Dysphagia, Post-extubation dysphagia (PED), Aspiration, Water swallowing test (WST), Fiberoptic endoscopic evaluation of swallowing (FEES)


Background: Post-extubation dysphagia (PED) is commonly reported in critically ill patients. Although dysphagia is not a fatal disease, it is an important medical condition that required the appropriate treatment. Early detection of PED is essential to reduce complications. There is no well-established standard screening and treatment protocol for surgical intensive care unit. The aims of this study are to report the incidence and identify the risk factors of PED in critically ill surgical patients.

Methods: This study is a prospective observational study. Two hundred patients who are intubated and on mechanical ventilation for ≥ 24 hours and successfully extubated without exclusion are needed to be enrolled. The patients will be performed water swallowing test (WST) at bedside in surgical ICU within 3-6 hours after extubation. For those patients who failed the WST, swallowing specialists will perform bedside fiberoptic endoscopic evaluation of swallowing (FEES) in SICU within 24-48 hours to establish the diagnosis of dysphagia. The primary outcome is the incidence and risk factors of post-extubation dysphagia. The secondary outcomes include time to resume oral diet after extubation, Functional Oral Intake Scale at follow-up, and adverse outcomes related with PED.

Discussion: The early detection of PED could be accomplished by using an effective screening tool, the WST, and confirmed the diagnosis by FEES performed by swallowing specialists. The incidence and risk factors of PED reported in this study will be helpful in developing the protocol for screening and treatment for PED in critically ill surgical patients.

Trial registration: The Thai Clinical Trials Registry (TCTR20211023003)
Registered on 23 October 2021


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How to Cite

Phothikun N, Thitisakulchai P, Tanvijit P, Yuyen T. The incidence and risk factors of post-extubation dysphagia in critically ill surgical patients: protocol for prospective observational study. Clin Crit Care [Internet]. 2022 Apr. 23 [cited 2024 Jun. 20];30:2022:e0006. Available from:



Research Protocol