Hassan A, Shah S, Bustamante N, et al.
Cureus. June 24, 2025; 17(6): e86640. https://doi.org/10.7759/cureus.86640
Summary:
This case report presents a detailed account of a male patient in his 60s who developed critical illness dysphagia (CID) following a pulseless electrical activity (PEA) arrest and prolonged intensive care unit (ICU) stay. After an extended period of mechanical ventilation and complications including sepsis and multi-organ dysfunction, the patient exhibited profound pharyngeal dysphagia with silent aspiration. Despite a complex and deteriorating course, coordinated multidisciplinary care led to progressive recovery and eventual discharge on a safe oral diet.
Key points:
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CID is a multifactorial condition often resulting from prolonged mechanical ventilation, neuromuscular weakness, oropharyngeal trauma, and disuse atrophy.
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The patient’s dysphagia was confirmed using fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallow study (VFSS).
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Multidisciplinary management included gastroenterology, neurology, endocrinology, speech-language therapy, and dietetics.
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The patient required prolonged nasogastric feeding but avoided percutaneous endoscopic gastrostomy (PEG) placement.
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Gradual progress with speech therapy enabled transition to an oral diet (IDDSI levels 2–3) and safe discharge without long-term enteral support.
This case underscores the importance of early identification of dysphagia, structured rehabilitation, and multidisciplinary collaboration. Instrumental assessments such as FEES and VFSS are critical in tailoring appropriate therapeutic strategies. With targeted intervention, patients with CID can achieve meaningful recovery and avoid long-term complications.
Thanks to Cureus for publishing this insightful case, which reinforces the clinical value of early dysphagia assessment and multidisciplinary care in ICU survivors.