TRACHEOSTOMY AND PREDISPOSITION TO DYSPHAGIA

Abstract

Introduction: Tracheostomy placement is a frequently used medical intervention for people with complex respiratory conditions. Given the anatomical location of a tracheostomy and the shared pathway of the respiratory and alimentary systems, tracheostomy can have unintended and even adverse consequences, one of these complications being dysphagia. Objectives: to identify whether tracheostomy can predispose to dysphagia. Materials and methods: This is an integrative review, in which the guiding question was “Does tracheostomy predispose to dysphagia?”. The search for articles was carried out in the main databases (PubMed and Scielo) using the terms “tracheostomy”, “dysphagia” and “deglutition disorders”, combined using Boolean operators. Results and discussion: The study findings demonstrated that intubation, use of tracheostomy and pronation were significantly associated with oropharyngeal dysphagia. Even in the absence of a swallowing problem before hospital admission, dysphagia during hospitalization has a detrimental effect on functional outcomes, especially in chronic critically ill patients with severe pneumonia who require a prolonged period of invasive ventilatory care and subsequently tracheostomy. Conclusion: We conclude that tracheostomy may predispose to dysphagia. Furthermore, it has been clarified that the main pathophysiology is due to the tracheostomy causing decreased sensory input, reduced subglottic air pressure, and disuse atrophy of laryngeal structures, thus leading to dysphagia.