ArticleBMC anesthesiology2023
A bedside swallowing screen for the identification of post-extubation dysphagia on the intensive care unit - validation of the Gugging Swallowing Screen (GUSS)-ICU.
Article in BMC anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 20 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Validation of the Gugging Swallowing Screen (GUSS-ICU) for the Intensive Care Unit
Evaluation of the Effects of Using the GUSS-ICU Safe Nutrition Program After Extubation in ICU Patients
Who cites it
20 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Korean clinical practice guidelines for rehabilitation in critically ill patients and post-intensive care syndrome.Acute and critical care · 2026Guideline
- Pooled it
- Characteristics, predictors, and management of post-extubation dysphagia in critically Ill children: a scoping review.Frontiers in pediatrics · 2026Pooled it
- Incidence of post-extubation dysphagia among critical care patients undergoing orotracheal intubation: a systematic review and meta-analysis.European journal of medical research · 2024Pooled it
- Trial
- Feasibility of Endoscopic Evaluations of Laryngeal Function After Extubation for Research in Critically Ill Adults.American journal of speech-language pathology · 2025Trial
- Assessment Tools for Intensive Care Unit-Acquired Dysphagia: A Network Meta-Analysis of Diagnostic Accuracy Studies.Dysphagia · 2026Review
- Korean Clinical Practice Guidelines for Rehabilitation in Critically Ill Patients and Post-Intensive Care Syndrome.Annals of rehabilitation medicine · 2026Article
- Article
- Reliability and validity of the DEFISS score for predicting post-extubation dysphagia and dysphagia-related reintubation after stroke.Scientific reports · 2026Article
- A pragmatic approach to identifying postextubation dysphagia in critically ill surgical patients using the water swallow test.Scientific reports · 2026Article
- Expert consensus-based clinical practice guidelines for Care and weaning procedures in tracheostomized ICU patients after invasive mechanical ventilation: a joint statement by the Intensive Care Physiotherapy Society (SKR) and the French Intensive Care Society (SRLF).Annals of intensive care · 2026Article
- Swallowing impairment and aspiration risk in clinically stabilized patients hospitalized for acute respiratory events: a cohort-wide machine-learning analysis with COPD-specific insights.Frontiers in medicine · 2026Article
- Diagnostic accuracy of the gugging swallowing screen (GUSS) in detecting aspiration and dysphagia in patients with unilateral vocal fold paralysis.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Article
- A Pilot Study of a Modified Swallowing Screening Tool for Critically Ill Patients in the Intensive Care Unit.Dysphagia · 2025Article
- Post-extubation dysphagia in the ICU-a narrative review: epidemiology, mechanisms and clinical management (Update 2025).Critical care (London, England) · 2025Review
- Using ML techniques to predict extubation outcomes for patients with central nervous system injuries in the Yun-Gui Plateau.Scientific reports · 2025Article
- Identifying dysphagia in the intensive care unit: Validation of the Swedish version of the Gugging swallowing screen-Intensive care unit.Acta anaesthesiologica Scandinavica · 2025Article
- [Treatment algorithm postextubation dysphagia].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Article
- Perspective on dysphagia screening, assessment methods, and protocols in intensive care units: an opinion article.Frontiers in human neuroscience · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeScreening for dysphagia at the intensive care unit (ICU) soon after extubation can prevent aspiration, pneumonia, lower mortality, and shorten re-feeding interval. This study aimed to modify the Gugging Swallowing Screen (GUSS), which was developed for acute stroke patients, and to validate it for extubated patients in the ICU.
methodsIn this prospective study, forty-five patients who had been intubated for at least 24 h were recruited consecutively at the earliest 24 h after extubation. The modified GUSS-ICU was performed twice by two speech and language therapists independently. Concurrently, gold standard the flexible endoscopic evaluation of swallowing (FEES) was performed by an otorhinolaryngologist. Measurements were conducted within a three-hour period; all testers were blinded to each other's results.
resultsAccording to FEES, 36 of 45 (80%) participants were diagnosed with dysphagia; 13 of those were severe, 12 moderate, and 11 mild. Compared to FEES, the GUSS-ICU predicted dysphagia well (area under the curve for the initial rater pair: 0.923, 95% CI 0.832-1.000 and 0.923, 95% CI 0.836 -1.000 for the second rater pair). The sensitivity was 91.7% (95% CI 77.5-98.3%) and 94.4% (95% CI 81.3-99.3%); the specificity was 88.9% (51.8-99.7%) and 66.7% (29.9-92.5%); the positive predictive values were 97.1% (83.8-99.5%) and 91.9% (81.7-96.6%), and the negative predictive values were 72.7% (46.8-89%) and 75% (41.9-92.6%) for the first and second rater pairs, respectively. Dysphagia severity classification according to FEES and GUSS-ICU correlated strongly (Spearman's rho: 0.61 for rater 1 and 0.60 for rater 2, p < 0.001). Agreement by all testers was good (Krippendorffs Alpha: 0.73). The interrater reliability showed good agreement (Cohen`s Kappa: 0.84, p < 0.001).
conclusionThe GUSS-ICU is a simple, reliable, and valid multi-consistency bedside swallowing screen to identify post-extubation dysphagia at the ICU.
trial registrationClinicalTrials.gov Identifier: NCT04532398,31/08/2020.
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