Post Esophageal Surgery Dysphagia and Nutritional Support in the Intensive Care Unit

Dysphagia is a frequent and clinically significant complication following esophageal surgery, particularly esophagectomy, and it poses substantial challenges in the postoperative management of critically ill patients. Impaired swallowing after surgery may arise from multiple mechanisms, including anatomical alterations, neural injury, postoperative inflammation, motility disorders, and anastomotic strictures. These factors can disrupt the coordinated physiological process of swallowing and increase the risk of serious complications. In the intensive care unit (ICU), early identification and appropriate management of dysphagia are essential to prevent adverse outcomes such as aspiration pneumonia, malnutrition, dehydration, and prolonged hospitalization. Comprehensive evaluation strategies—including bedside clinical assessment, standardized screening tests, and instrumental diagnostic methods such as videofluoroscopic swallow study and fiberoptic endoscopic evaluation of swallowing—play a crucial role in detecting swallowing dysfunction and guiding clinical decisions. Nutritional management is another key component of postoperative care, as patients with dysphagia often experience inadequate oral intake during the early recovery phase. Early initiation of nutritional support, preferably through enteral routes, helps maintain metabolic stability and supports tissue healing. Multidisciplinary collaboration among intensivists, surgeons, dietitians, and speech language pathologists is fundamental for optimizing patient outcomes. Rehabilitation strategies, including swallowing therapy, postural adjustments, and targeted muscle exercises, can facilitate functional recovery and reduce aspiration risk. In addition, structured ICU protocols and enhanced recovery pathways may contribute to improved postoperative outcomes by promoting safe nutritional progression and coordinated care.

کلیدواژه ها:

postoperative dysphagia ، Esophagectomy ، Nutritional support ، Intensive Care Unit