{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:45:35Z","timestamp":1791323135564,"version":"4.3.1"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2024,11]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Post\u2010extubation dysphagia (PED) is a common post\u2010extubation complication that may lead to serious problems, such as malnutrition and longer hospital and intensive care unit (ICU) stays.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n To explore factors associated with the readiness for oral intake in post\u2010extubated critically ill adult patients.<\/jats:p>\n <\/jats:sec>\n \n Study Design<\/jats:title>\n This prospective observational study involved 125 extubated patients. Readiness for oral intake was assessed using the Gugging Swallowing Screen (GUSS), and regression analysis was used to determine its predictors.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The median age of the participants was 40.0\u2009years, and 51.2% were female. The median GUSS score was 12.0 (possible range, 0\u201320), and 35.2% of the studied patients had severe dysphagia (scored 0\u20139). Bivariate regression analysis showed that older age, male, higher APACHE II score, body mass index (BMI) \u226530, smoking history, longer ICU stay, muscle relaxants use, large\u2010bore endotracheal and orogastric tubes and frequent intubation attempts were associated with lower GUSS score (\n p<\/jats:italic>\n \u2010value <.05). Multivariate regression analysis showed that age, BMI and smoking history predicted 37.2% of the variability in the GUSS score (\n F<\/jats:italic>\n \u2009=\u200923.865,\n p<\/jats:italic>\n \u2010value <.001). Adding the ICU length of stay, muscle relaxants use, size of the endotracheal tube, size of the orogastric tube and frequency of intubation attempts to the regression model raised the predictability to 86.0% (\n F<\/jats:italic>\n \u2009=\u200988.809,\n p<\/jats:italic>\n \u2010value <.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n More than one\u2010third of extubated patients have severe PED with a high risk of aspiration. Several modifiable factors, such as muscle relaxant use and endotracheal and orogastric tube size, predict post\u2010extubation readiness for oral intake.<\/jats:p>\n <\/jats:sec>\n \n Relevance to Clinical Practice<\/jats:title>\n Using endotracheal and orogastric tubes of appropriate sizes, careful assessment of patients with a high risk for difficult intubation, and minimal use of muscle relaxants may help increase patients' readiness for post\u2010extubation oral intake.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nicc.13109","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T06:29:45Z","timestamp":1718778585000},"page":"1555-1563","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Factors associated with the readiness for oral intake in post\u2010extubated critically ill adult patients: A prospective observational study"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2065-7494","authenticated-orcid":false,"given":"Shimmaa Mohamed","family":"Elsayed","sequence":"first","affiliation":[{"name":"Critical Care and Emergency Nursing Department, Faculty of Nursing Damanhour University Damanhour Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1349-4578","authenticated-orcid":false,"given":"Sameh","family":"Eltaybani","sequence":"additional","affiliation":[{"name":"Global Nursing Research Center The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maysa Abdalla","family":"Elbiaa","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Nursing Department, Faculty of Nursing Matrouh University Matrouh Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4037\/ccn2023722"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871\u2010023\u201002072\u20106"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29311"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2021.03.008"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010016\u20101507\u2010y"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010020\u201000752\u2010x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2023.154447"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2024.1375408"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010019\u201009977\u2010w"},{"key":"e_1_2_9_11_1","unstructured":"LederSB SuiterDM.The Yale Swallow Protocol.2014;3\u20104. doi:10.1007\/978\u20103\u2010319\u201005113\u20100"},{"key":"e_1_2_9_12_1","unstructured":"CraryC.Mann\u2010Assessment\u2010of\u2010Swallowing\u2010Ability\u2010MASA.pdf.2014."},{"key":"e_1_2_9_13_1","unstructured":"BarnesG.Swallowing after Extubation: what to know and what to look for.2022.https:\/\/medslpcollective.com\/Swallowing-After-Extubation.%0A2022"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000033153"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.05.576"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(07)61602\u2010X"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.12968\/ijpn.2020.26.6.284"},{"key":"e_1_2_9_18_1","unstructured":"RaosoftInc.Sample size calculator.2004.http:\/\/www.raosoft.com\/samplesize.html"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.483933"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12333"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871\u2010023\u201002072\u20106"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2021.102837"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2021.07.009"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.024643"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40140\u2010020\u201000416\u20103"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003465\u2010198603000\u201000013"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12343"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16039"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010023\u201010568\u2010z"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010019\u201005865\u2010x"},{"key":"e_1_2_9_32_1","unstructured":"MathematicsA.Postextubation dysphagia. 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