Oropharyngeal ultrafast ultrasound measurements in mechanically ventilated critically ill patients do not identify post-extubation stridor
Authors' conclusion
Oropharyngeal SWE is feasible in critically ill patients before extubation, but was not predictive of post-extubation stridor.
Study context
- Population
- Adult ICU patients intubated >24 h, without prior surgical or neurological upper airway disease or swallowing disorders125 analysed
- Participants
- 150 patients
- Exposure
- Stridor vs No stridor
- Outcome
- Post-extubation stridor (detection by pre-extubation upper airway SWE)
- Follow-up
- Within 72 h
Methodological detailsconsecutive inclusion, shear wave elastography (SWE) measurements performed in the 24 h before extubation
- Consecutive inclusion
- SWE measurements performed in the 24 h before extubation
Main finding
As reported in the abstract
Post-extubation stridor
Post-extubation stridor incidence
9%
Stridor independently associated with sepsis at admission
8.98
OR 8.98; 95% CI 1.3–62.1
Observational data: associations, not effects.
Further findings
Swallowing disorders: independent association with duration of mechanical ventilation
| OR (95% CI) | ||
|---|---|---|
| Duration of mechanical ventilation | 1.10 (1.04–1.17) | |
| 0.512Odds ratio (log scale) |
Dysphonia: associated factors
| OR (95% CI) | ||
|---|---|---|
| Female sex | 3.23 (1.24–8.37) | |
| Sternothyroid muscle stiffness | 1.11 (1.04–1.18) | |
| Days of mechanical ventilation | 1.09 (1.02–1.15) | |
| 0.10.31310Odds ratio (log scale) |
Feasibility: interpretable ultrasound images
- Ultrasound images obtained
- 2,625
- Images deemed interpretable
- 81%
Dysphonia, swallowing disorders and extubation failure by stridor
- Dysphonia, stridor vs no stridor
- 82% vs. 23%
- Swallowing disorders, stridor vs no stridor
- 36% vs. 11%
- Extubation failure, stridor vs no stridor
- 46% vs. 10%
Original publication
Oropharyngeal ultrafast ultrasound measurements in mechanically ventilated critically ill patients do not identify post-extubation stridor. Crit Care. Published 25 September 2025. doi:10.
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