Dysphagia, or difficulty swallowing, is a common problem for people who are very sick in the hospital. It can lead to serious complications like pneumonia, malnutrition, and longer hospital stays. This review looked at 20 studies involving 2,198 patients to see if neurostimulation therapies could help. Neurostimulation uses mild electrical or magnetic pulses to activate nerves and brain areas involved in swallowing. The therapies studied included transcutaneous auricular vagus nerve stimulation (ta-VNS), neuromuscular electrical stimulation (NMES), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and pharyngeal electrical stimulation (PES). These were compared to traditional dysphagia therapy, usual care, or sham stimulation.
The results showed that neurostimulation therapies, especially when combined with traditional dysphagia therapy, significantly improved swallowing function right after treatment. Patients also had a 39% higher chance of being able to eat by mouth again. The benefits lasted for up to two months after treatment. Additionally, pneumonia rates dropped by about 38% in patients who received neurostimulation. However, at three months, the improvement in swallowing was no longer significant, suggesting that the effects may fade over time.
Not all outcomes were positive. The therapies did not significantly reduce the risk of aspiration (food or liquid going into the lungs), help with decannulation (removing a breathing tube), or shorten hospital stays. The review also noted that the combination of NMES with traditional dysphagia therapy might be the most effective approach, but more research is needed to confirm this.
The studies were generally well-designed, but there were some limitations. For example, the effectiveness of ta-VNS combined with traditional therapy was based on only one study, so it needs more investigation. Overall, this review provides strong evidence that neurostimulation therapies can be a valuable addition to standard care for critically ill patients with swallowing problems.
If you or a loved one is in the hospital and having trouble swallowing, talk to the medical team about whether neurostimulation therapy might be an option. These treatments are non-invasive and can be done at the bedside. They may help improve swallowing and reduce the risk of pneumonia, which can be a serious complication.