Silent Aspiration Following Extubation in the ICU

Starting soon

Conditions studied: Silent Aspiration, Post-Extubation Dysphagia, Deglutition Disorders, Critical Illness, Mechanical Ventilation Complication

In brief

Post-extubation dysphagia is common in critically ill patients and may lead to silent aspiration, which often remains undetected because patients do not exhibit overt clinical signs such as coughing or choking. Current bedside nursing swallow screening may fail to identify silent aspiration in patients recovering from prolonged mechanical ventilation. The goal of this observational study is to learn about the incidence, risk factors, and clinical outcomes of silent aspiration in critically ill adult patients who require prolonged mechanical ventilation and are extubated in the ICU. The main questions it aims to answer are: * How often does silent aspiration occur in ICU patients intubated for 5 days or longer after extubation? * Can silent aspiration be present despite passing the routine bedside nursing swallow screen? * What clinical factors are associated with silent aspiration? * Is silent aspiration associated with worse clinical outcomes such as aspiration pneumonia, reintubation, prolonged ICU stay, ventilator-free days, or mortality? Participants who have been mechanically ventilated for 5 days or more will undergo routine bedside swallow screening followed by Fiberoptic Endoscopic Evaluation of Swallowing (FEES), considered the gold-standard diagnostic tool for detecting silent aspiration, within 72 hours after extubation. Researchers will compare bedside nursing swallow screening results with FEES findings to evaluate the diagnostic accuracy of bedside screening in detecting silent aspiration. Clinical data, swallowing assessment findings, and patient outcomes will also be collected and analyzed.

Key facts

Study ID

NCT07635888

Run by

Cleveland Clinic Abu Dhabi

People needed

274

Starts

2026-06-01

Expected to finish

2028-06-01

Last updated by the study team

2026-06-09

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Adult ICU patients requiring invasive mechanical ventilation for 5 days or longer
• Successful extubation after invasive mechanical ventilation
• Undergoing bedside nursing swallow screening after extubation
• Ability to undergo Fiberoptic Endoscopic Evaluation of Swallowing (FEES) within 72 hours after extubation
• Provision of informed consent by the patient or legally authorized representative

You may not qualify if…

• Presence of tracheostomy
• Do-not-reintubate orders/Allow natural death
• Pregnancy
• Absence of informed consent
• Contraindication to FEES as determined by the treating physician (e.g., high bleeding risk or severe oxygen requirements)

Where it is running

• Cleveland Clinic Abu Dhabi — Abu Dhabi, United Arab Emirates

Full record on ClinicalTrials.gov

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