SOC program and usual care
death
Participants in the SOC group, in addition to the usual care, received daily SOC for seven days or until death or hospital discharge (whichever occurred first) starting on the day following extubation (regardless of intake status). The SOC consisted of three protocols: oral motor exercise (exercises for the lips, tongue, jaw, and cheeks), sensory stimulation and lubrication (thermal-tactile stimulation, toothbrushing, and salivary-gland massage), and safe-swallowing education (Additional file Usual care consisted of daily oral care, provided each shift by ICU nurses using oral swabs and rinsing with 2% chlorhexidine gluconate. A rehabilitation doctor or SLP provided additional care only at the attending physician’s request. No standardized oral or swallowing care was routinely provided for post-extubated patients after their ward transfer.