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Concepts in Ventilator Weaning: Challenges for the Patient With Dysphagia

Department of Rehabilitation Services, The Silvercrest Center for Nursing and Rehabilitation; New York Hospital Queens, Center for Digestive Diseases and Swallowing Disorders
Queens, NY

Marta Kazandjian

Department of Rehabilitation Services, The Silvercrest Center for Nursing and Rehabilitation; New York Hospital Queens, Center for Digestive Diseases and Swallowing Disorders
Queens, NY

Helene Lerner

Dining Services, Morrison Senior Dining, The Silvercrest Center for Nursing and Rehabilitation
Queens, NY

The care of the mechanically ventilated patient has evolved over the past several decades. Individuals who have had tracheostomies and are dependent on ventilators often experience a devastating loss of communication and swallowing function. More and more frequently, speech-language pathologists are called upon to assist in the care of these patients with medically complex conditions as part of a comprehensive interdisciplinary team. When working with patients who are being weaned from a ventilator, speech-language pathologists must appreciate the interaction between respiration and swallowing. Impairment in these systems is closely linked, due to the potential influences of upper airway flow and pressure on normal swallowing physiology. In conjunction with other co-morbidities of chronic illness, such as recurrent infections and decreased nutrition, the loss of consistent upper airway flow affects the ventilator weaning process. As a team member, the speech-language pathologist supports the communication and swallowing needs of patients, facilitating these processes throughout recovery and during movement toward liberation from mechanical ventilation.