Role of ultrasonography in the evaluation of dysphagia in critically ill patients: A narrative review

Dysphagia, defined as difficulty in swallowing, significantly impacts critically ill patients, especially those in intensive care units (ICUs). It can arise from neuromuscular disorders or mechanical obstructions, often exacerbated by prolonged mechanical ventilation and other medical interventions. Dysphagia poses risks such as aspiration pneumonia, malnutrition, and prolonged hospital stays. Early detection and intervention are crucial. A comprehensive literature search was conducted using PubMed, SCOPUS, and SPRINGER databases from December 2023 to February 2024. Search terms included “screening,” “dysphagia,” “ICU,” “ultrasonography,” “swallowing function,” and “deglutition disorders.” The search yielded 43 relevant articles, which were subjected to narrative analysis. Traditional dysphagia assessment methods include bedside evaluations, swallow tests, and instrumental strategies like video fluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES). Ultrasonography (US) emerges as a promising, non-invasive alternative for evaluating swallowing function. US can assess tongue and hyolaryngeal movements, and upper esophageal sphincter function, offering real-time feedback and aiding in diagnosis and therapeutic planning. Despite its benefits, US lacks standardized protocols and comprehensive diagnostic criteria, necessitating further research. Ultrasonography shows significant potential in evaluating and managing dysphagia in critically ill patients due to its non-invasive nature and real-time feedback capabilities. However, variations in techniques and the need for standardized diagnostic criteria present challenges. Future research should focus on standardizing ultrasound parameters and refining diagnostic criteria to enhance its reliability and accuracy. Despite these challenges, ultrasonography remains a promising tool for dysphagia assessment and intervention.