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Bulbar issues frequently impact the care of patients who are being ventilated. Careful assessment and management of swallowing and laryngeal function will affect weaning decisions, extubation success and patients’ experience whilst on ITU. We will consider how and when to deliver targeted assessments and interventions that seek to minimise the impact of bulbar dysfunction. We will discuss how strategies to optimise patients’ ability to verbally communicate whilst being ventilated can be implemented, and the contribution of these strategies to weaning success.