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The following is a summary of “Pharyngeal Electrical Stimulation prior to extubation – Reduction of extubation failure rate in acute stroke patients?,” published in the April 2024 issue of Critical Care by Muhle et al.

Researchers conducted a prospective study investigating whether pharyngeal electrical stimulation (PES) applied before extubation could reduce the risk of extubation failure in orally intubated patients with mechanically ventilated stroke with a high likelihood of severe dysphagia.

They enrolled 32 patients in ICU, all at high risk for dysphagia according to a DEFISS (Determine Extubation Failure In Severe Stroke) risk score, and matched them 1:1 with a retrospective control group. The patient group received PES before extubation. Endpoints included reintubation need, swallowing function assessed via FEES, pneumonia incidence, and post-extubation length of stay.

The results showed that post-extubation, the Fiberoptic Endoscopic Dysphagia Severity Score (FEDSS) was lower in the PES group compared to the historical control group (4.31 ± 1.53 vs. 5.03 ± 1.28; P=0.047), and the reintubation rate within 72 hours was also lower (9.4% vs. 34.4%; P=0.032). Pulmonary infections after extubation were less common in PES-treated patients, though not significantly different (37.5% vs. 59.4%; P=0.133). Time from extubation to discharge was significantly shorter after PES than the control group (14.09 ± 11.58 vs. 26.59 ± 20.49 days; P=0.003).

Investigators concluded that PES use in patients with high-risk stroke showed promise for improved swallowing function, reduced extubation failure, and faster discharge, but further studies are needed.

Source: sciencedirect.com/science/article/pii/S0883944124002958