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Library of the School of Health Sciences

2024-07-18

2024

Kostakou Vasiliki

Ροβίνα Νικολέτα , Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σιδηράς Γεώργιος, Προϊστάμενος Μονάδας Εμφραγμάτων, ΓΝΑ «Ο Ευαγγελισμός»
Μαρκάκη Βάλια, Διευθύντρια ΕΣΥ, A’ Κλινική, Εντατικής Θεραπείας Νοσοκομείου «Ευαγγελισμός»

Η δυσφαγία σε ασθενείς της μονάδας εντατικής θεραπείας και η συσχέτισή της με την μυϊκή αδυναμία της μονάδας (ICUAW)

Greek

Dysphagia in intensive care unit patients and its association with intensive care unit aquired weαkness (ICUAW)

Introduction: Patients hospitalized in the intensive care unit (ICU) can often develop swallowing disorders, resulting in the inability to effectively transport fluid and food. It is an important disorder that occurs in critically ill patients and in combination with ICU-acquired weakness (ICU-acquired weakness) affects the treatment and prognosis of the disease. Although dysphagia is not considered a disease but a symptom or complication of another disease, it is responsible for a number of respiratory tract infections, aspiration, prolonged hospitalization, dehydration, malnutrition, weight loss and even death.

Purpose: The purpose of the study was to collect data on the probability of occurrence of dysphagia in ICU patients as well as to present its correlation with the occurrence of muscle weakness in these patients.

Methodology: The study was a prospective observational study and was carried out in the ICU KAA and PP of the Sotiria Thoracic Diseases Hospital of Athens. The study lasted 3 months. All patients admitted to hospital ICUs with a stay on mechanical ventilation for at least 3 days were evaluated. A total of 55 patients were admitted to the intensive care units, of which 38 were excluded. Of the 17 patients, 15 were evaluated due to 2 deaths. The study used the Ohkuma questionnaire, among others, to investigate pre-existing dysphagia. Dysphagia was assessed using a clinical observation protocol. The Blue Dye Test was administered to tracheostomy patients. The Functional Oral Intake Scale (FOIS) was used to classify patients according to their level of swallowing difficulty. The Medical Resource Council (MRC) muscle strength rating scale and hand grip dynamometry were used to clinically assess muscle strength for the diagnosis of muscle weakness (ICUAW).

Results: We observed that the evaluated patients showed dysphagia with a mean FOIS value of 3±2. There was a correlation between the appearance of dysphagia and the appearance of muscle weakness of the unit mainly in female patients (p=0.036). Glossopharyngeal, vagus, hypoglossal, and trigeminal nerve weakness also occurred. Finally, aspiration was observed according to the Blue Dye Test protocol and difficulty in feeding-swallowing the different consistencies given.

In the study there was no possibility of imaging assessments, which could have given us useful information and influenced the results of our research.

Conclusions: In conclusion, dysphagia occurs in patients hospitalized in the intensive care unit and is associated with the occurrence of muscle weakness in the unit. Patients also experienced aspiration and reduced oral intake.

Health Sciences

Dysphagia, ICU, ICUaW, Tracheostomy, Mechanical ventilation

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https://pergamos.lib.uoa.gr/uoa/dl/object/3400698