Participants and settings
stroke, parkinsonism, head and neck deformities
PARKINSONISM, STROKE, TUBERCULOSIS, NEUROMUSCULAR DISEASE, DIFFICULTY SWALLOWING
This trial was conducted at six medical ICUs at a tertiary medical center in Taipei, Taiwan. Consecutive patients (≥ 20 years old) were recruited from September 2017 to July 2020 if they had received emergency oral endotracheal intubation for at least 48 h and had been successfully extubated. Patients were excluded if they (1) had a history of neuromuscular disease (e.g., parkinsonism or stroke) or head and neck deformities, (2) had preexisting difficulty swallowing, (3) had received a tracheostomy, (4) were unable to follow verbal instructions, (5) were on contact and droplet precautions (e.g., open tuberculosis), or (6) were receiving continuous noninvasive ventilation after extubation that precluded the delivery of an SOC intervention.