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Hassan et al.
Cureus. June 24, 2025; 17(6): e86640. https://doi.org/10.7759/cureus.86640
This case report describes a male in his 60s who developed severe dysphagia after a prolonged ICU stay for pulseless electrical activity arrest, mechanical ventilation, and bacteremia. His swallowing impairment was diagnosed using FEES and VFSS, revealing profound pharyngeal dysfunction and silent aspiration. Structural and neurologic causes were ruled out. A multidisciplinary team implemented a structured rehabilitation plan, leading to gradual improvement. After a period of nasogastric feeding, he was discharged tolerating a modified oral diet.
The report highlights the multifactorial pathophysiology of critical illness dysphagia, including central and peripheral neurologic involvement, ICU-acquired weakness, disuse atrophy, and medication effects. Clinical tools such as FEES and VFSS are essential for early detection and management. This case underscores the importance of coordinated care across specialties to support functional recovery and reduce risks like aspiration pneumonia and prolonged hospitalization. With appropriate therapy, patients with CID can regain safe swallowing and avoid long-term enteral dependence.
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