To map available evidence on pediatric post-extubation dysphagia (PED), focusing on incidence, predictors, and management strategies, including assessment tools and intervention protocols.
Key Findings:
Clinical incidence of PED ranges from 28.36% to 68.94%, indicating a significant clinical concern.
Independent predictors categorized into three tiers: intubation duration, age, and IWS (Tier 1); neurological comorbidities and multiple intubations (Tier 2); delirium (Tier 3), highlighting the complexity of risk factors.
The CRISPED score is the only prediction tool with internal validation (C-statistic 0.85–0.86), suggesting a need for further validation.
No bedside assessment instrument validated against VFSS or FEES, indicating a critical gap in assessment methodologies.
Interventions focused on oral motor training, lacking standardization in frequency, intensity, or multidisciplinary integration, which may affect outcomes.
Interpretation:
Pediatric PED shows high incidence and common risk factors, but significant methodological inconsistencies exist in diagnostic definitions and assessment tools, necessitating standardized approaches.
Limitations:
Absence of instrumental validation for bedside assessment tools limits clinical applicability.
Lack of gold-standard diagnostic accuracy studies hampers the reliability of findings.
No externally validated prediction models restrict the generalizability of results.
Conclusion:
Future research should prioritize multicenter studies to unify diagnostic criteria, develop standardized assessment and management pathways, and address identified methodological gaps.
