Dysphagie und Trachealkanülen-Management auf der Neuro-ICU – Ursachen, Erkennen, Handling und therapeutische Ansätze

Bei Patienten auf der neurologischen Intensivstation finden sich häufig Dysphagien, die durch die Grunderkrankung, aber auch durch die intensivmedizinische Behandlung selbst verursacht sein können. Schluckstörungen stellen häufig ein Hindernis für die erfolgreiche Entfernung einer Trachealkanüle dar. Die Zusammenhänge zwischen Dysphagie und Tracheotomie, deren Management und aktuelle Therapieoptionen werden in diesem Beitrag beleuchtet.

Abstract

Dysphagia is frequently found in patients treated in the neurological intensive care unit. They can be caused both by the underlying disease, such as a stroke, and by the intensive care treatment itself and are associated with an increased risk of aspiration pneumonia, malnutrition and a reduced quality of life. After successful weaning from mechanical ventilation, dysphagia, in addition to airway stenosis or an impaired cough, is often an obstacle to the successful removal of a tracheostomy tube. The flexible endoscopic evaluation of swallowing (FEES), which can be performed at the bedside, can be used to appropriately classify and objectively assess the individual dysphagia pattern. This can also be used to assess whether there is sufficient swallowing safety before decannulation. There are a number of treatment options with the aim of achieving safe decannulation. These include the established occlusion training, but increasingly also neuromodulatory therapy approaches such as pharyngeal electrical stimulation. In this article, we would like to highlight the links between dysphagia and tracheostomy, their management and the current treatment options.

Schlüsselwörter

Dysphagie - Schlucken - FEES - Tracheotomie - Dekanülierung

Key Words

dysphagia - swallowing - FEES - tracheostomy - decannulation

Publication History

Article published online:
24 January 2025

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