What is critical illness myopathy and what does it have to do with tracheostomy and ventilation?
Answer
Critical illness myopathy may occur in a medically complex patient who remains absent from functional activity for an extended period. This patient no longer has the resistance throughout the day needed to build their muscles. 62% of people who become ventilator-dependent begin to have some level of neuromuscular weakness (Shepherd et al., 2016). The reason the SLP needs to be aware of the high incidence of critical illness myopathy in the tracheostomy and ventilator dependent population is that the weakness is often widespread, substantial, and not limited to areas of the body that are below the neck. Lingual, labial, laryngeal, and pharyngeal function is often impacted by critical illness myopathy, causing significant issues with speaking and swallowing. This may lead to increased dependence and higher risks involved with introducing food and liquid; not only because of the high risk of aspiration but also because that aspiration may be more likely to result in a subsequent infection (Langmore et al., 1998 and 2002).
George Barnes MS CCC-SLP has developed an expertise in dysphagia with a focus on diagnostics in the medically complex population through his dedication to a variety of medical settings. George yearns to make education useful, research clinical-focused, and quality care accessible. His coaching program with FEESible Swallow Solutions supports SLPs with the guidance they need to reach their clinical and career goals. He co-founded a mobile FEES service to bring the highest quality assessment to the patient's bedside. His webinars bridge research and patient care. George strives to go beyond the swallow in dysphagia management by looking at the whole patient which is evident in his work on a pneumonia risk calculator. With a passion for food and a deep appreciation for the joy and connection it gives to our lives, he has dedicated his life to helping others enjoy this simple, but deep-rooted pleasure.
Related Courses
1https://www.speechpathology.com/slp-ceus/course/20q-beyond-swallow-tracheostomy-tube-1005620Q: Beyond the Swallow - Tracheostomy Tube and Ventilator ManagementThis course addresses the various questions that may arise for the medical SLP involved in the care of patients with tracheostomy and/or mechanical ventilation. Topics include causes of respiratory failure, consequences of tracheostomy/ventilation, risk management related to intervention, and considerations for assessment and treatment of swallowing and communication, including the use of speaking valves.textual, visual
This course addresses the various questions that may arise for the medical SLP involved in the care of patients with tracheostomy and/or mechanical ventilation. Topics include causes of respiratory failure, consequences of tracheostomy/ventilation, risk management related to intervention, and considerations for assessment and treatment of swallowing and communication, including the use of speaking valves.
2https://www.speechpathology.com/slp-ceus/course/eating-again-after-extubation-case-10582Eating Again After Extubation: A Case StudyKey factors related to respiratory failure and oral intubation, including levels of respiratory support and effects of intubation on the larynx and swallow, are reviewed in this course. A decision-making framework for creating evidence-based, individualized plans of care is described within the context of a case study.auditory, textual, visual
Key factors related to respiratory failure and oral intubation, including levels of respiratory support and effects of intubation on the larynx and swallow, are reviewed in this course. A decision-making framework for creating evidence-based, individualized plans of care is described within the context of a case study.
3https://www.speechpathology.com/slp-ceus/course/eating-again-after-trach-vent-10638Eating Again After Trach/Vent: A Case StudyThe research and theoretical framework behind trach/vent management, including elements of decision-making and risk assessment and management, are described in this course. A complex case study of resuming oral intake in a patient with trach/vent is presented to provide an in-depth look at real-world application of this information.auditory, textual, visual
The research and theoretical framework behind trach/vent management, including elements of decision-making and risk assessment and management, are described in this course. A complex case study of resuming oral intake in a patient with trach/vent is presented to provide an in-depth look at real-world application of this information.
4https://www.speechpathology.com/slp-ceus/course/breathe-speak-eat-what-slp-10445Breathe, Speak, Eat: What the SLP Needs to Know About Respiratory FailureThis is Part 1 of a two-part series. Respiratory disease, respiratory failure, oral intubation, effects of intubation on the larynx and the swallow, and dysphagia management are discussed in this course. Risk factors and salient features of dysphagia after extubation are described in order to help clinicians effectively evaluate and treat their patients.auditory, textual, visual
This is Part 1 of a two-part series. Respiratory disease, respiratory failure, oral intubation, effects of intubation on the larynx and the swallow, and dysphagia management are discussed in this course. Risk factors and salient features of dysphagia after extubation are described in order to help clinicians effectively evaluate and treat their patients.
5https://www.speechpathology.com/slp-ceus/course/breathe-speak-eat-what-slp-10461Breathe, Speak, Eat: What the SLP Needs to Know About Trachs and VentsThis is Part 2 of a two-part series. An overview of tracheostomy tube and mechanical ventilator management, including their effects on airflow, speech and swallowing, is provided in this course. Discussion includes speaking valves, common challenges, and ways to improve outcomes in this complex patient population.auditory, textual, visual
This is Part 2 of a two-part series. An overview of tracheostomy tube and mechanical ventilator management, including their effects on airflow, speech and swallowing, is provided in this course. Discussion includes speaking valves, common challenges, and ways to improve outcomes in this complex patient population.
