Journal
INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY
Volume 23, Issue 1, Pages 83-91Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/17549507.2020.1744727
Keywords
Intensive care; FEES; dysphagia; aspiration; deglutition disorders
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This study demonstrated the significance of FEES in accurately diagnosing dysphagia and adjusting oral diet in neurological intensive care unit patients. The findings suggest that FEES can potentially contribute to lower mortality and morbidity rates in critically ill patients.
Purpose: Dysphagia is common in critically ill neurological patients and is associated with a high mortality and morbidity. Data on the usefulness of flexible endoscopic examination of swallowing (FEES) in neurological intensive care unit (ICU) patients are lacking, raising the need for evaluation. Method: FEES was performed in neurological intensive care patients suspected of dysphagia. We correlated findings with baseline data, disability status, pneumonia and duration of hospitalisation, as well as a need for mechanical ventilation or tracheotomy. Result: This analysis consisted of 125 patients with suspected dysphagia. Most of the patients (81; 64,8%) suffered from acute stroke. Dysphagia was diagnosed using FEES in 90 patients (72%). FEES results led to dietary modifications in 80 patients (64%). The outcome at discharge was worse in dysphagic stroke patients diagnosed by FEES as compared to non-dysphagic stroke patients (p = 0.009). Patients without oral diet had higher need for intubation (p = 0.007), tracheotomy (p = 0.032) and higher mortality (p < 0.001) in comparison to patients with at least small amounts of oral intake. Conclusion: As the clinical assessment of the patients often classified the dysphagia incorrectly, the broad use of FEES in ICU patients might help to adequately adjust patients' oral diet. This knowledge might contribute to lower mortality and morbidity.
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