Despite having the tools and techniques for tracheal intubation for > 4000 years, and performing oral intubation with positive pressure mechanical ventilation for > 50 years, only recently has attention focused on patient issues following extubation, particularly swallowing-related complications.

The endotracheal tube traverses the oropharynx, larynx, and trachea, with potential for laryngeal and tracheal injury, voice dysfunction, and dysphagia (i.e., swallowing dysfunction).

Aspiration (i.e., one consequence of dysphagia) is present in ≥ 40% of medical-surgical and cardiac patients post-extubation.

When an instrumental evaluation of swallowing demonstrates dysphagia with aspiration, there are important clinical concerns regarding pneumonia, with implications for the ICU team.

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