The Effects on Oral and Pharyngeal Structures, Articulation and Phonation Functions following Prolonged Endotracheal Intubation

• Main Authors: Kuo-Hsiang Wu, 吳國湘
• Other Authors: Cheryl Chia-Hui Chen
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/00993881646276781249

碩士 === 國立臺灣大學 === 護理學研究所 === 102 === Background: With advances in medical science, an increasing number of patients require airway support and are able to wean from mechanical ventilation. However, orotracheal tube intubation may have temporary, even permanent effects on oral and pharynx structures and functionality of articulation and phonation. Purpose: To investigate the prevalence of oral and pharynx damage and impairments of articulation and phonation after prolonged endotracheal intubation. Method: We conducted a prospective, longitudinal study with a consecutive sampling. Participants were recruited consecutively from 6 medical intensive care units at an urban medical center in Taiwan. Participants’ oral and pharynx structures, articulation and phonation functions were assessed at three time points: 48 hours within extubation, and 7th and 14th day post-extubation. Result: In total, 50 participants were included in this study (33 males and 17 females, age of 60.7±14.9 years, and average length of intubation was 7.9±5.3 days). The prevalence of sore throat was 54%. The prevalence rates of oral ulcers were 68.2%, 48.6%, and 28%, respectively, within 48 hours, 7th and 14th day after extubation. The articulation was significantly affected but about half of the participants recovered within 14 days after extubation. Seven days after extubation, the quality of voice, measured by S/Z ratio, was higher than 1.4 suggesting impairment on phonation. At 14th day after extubation, although S/Z ratio was back to normal, most patients still presented with shorter durations of S and Z sound suggesting pulmonary insufficiency. Overall, the oral conditions after extubation, measured by the oral assessment guide were poor with scores ranged from 16.3±2.4, 13.8±3.7 and 12.4±3.1, respectively (p <0.001). Conclusion: The impairments on oral and pharynx structures, articulation, and phonation were highly prevalent after prolonged orotracheal intubation and the recovery of these conditions may take 2 weeks, or even longer.