Study on Oral Intake Initiation and Prevention of Aspiration Pneumonia Based on Swallowing Function Evaluation After Extubation in Intubated Patients

2023 Fiscal Year Final Research Report

• Project/Area Number: 17K11596
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Emergency medicine
• Research Institution: Nippon Medical School
• Principal Investigator: Hidetaka Onda 日本医科大学, 医学部, 助教 (30521603)
• Co-Investigator(Kenkyū-buntansha): 布施 明 日本医科大学, 医学部, 教授 (80238641) ; 増野 智彦 日本医科大学, 医学部, 講師 (00318528) ; 横堀 将司 日本医科大学, 医学部, 准教授 (70449271)
• Project Period (FY): 2017-04-01 – 2024-03-31
• Keywords: 嚥下 / 挿管 / 集中治療

Outline of Final Research Achievements

The removal of an endotracheal tube is an invasive procedure, necessitating a protocol. Swallowing evaluations were implemented to prevent dangerous extubations and achieve more accurate assessments. Based on risk factors, patients were divided into two groups: one started oral intake as planned, while the other followed usual practices. We compared re-intubation and aspiration pneumonia rates between the groups. Cases of aspiration pneumonia and re-intubation were objectively evaluated to determine the effectiveness of initiating oral intake timing. High-risk patients included those using vasopressors, aged 65 or older, or with aspiration pneumonia as an underlying condition. Recognizing the importance of thorough swallowing evaluations and risk management is crucial for effective treatment.

Free Research Field

救急医学

Academic Significance and Societal Importance of the Research Achievements

本介入研究により、抜管後に、誤嚥性肺炎の合併や、再挿管となる症例が、どのように異なるかを客観的に評価し、経口摂取開始時期決定の有効性を検討した。昇圧剤の使用、高齢者の65歳以上、および原疾患が誤嚥性肺炎である症例は、抜管自体にリスクが認められ、またその後の経口摂取に関しても他症例のようにスムーズに進まなかった。嚥下評価やリスクを熟知して治療、嚥下を進めていく必要性が認められた。