Acurácia da avaliação clínica da disfagia orofaríngea na encefalopatia crônica não progressiva

Santos, Rogério Gonçalves dos; Sales, André Vinicius Marcondes Natel; Cola, Paula Cristina; Jorge, Adriana Gomes; Peres, Fernanda Matias; Furkim, Ana Maria; Berti, Larissa Cristina; Silva, Roberta Gonçalves da

doi:10.1590/1982-0216201416112

“…It is therefore probable that changes in swallowing are not being identified and dealt with in a timely manner, thus increasing the risk of gradual worsening. Similar findings have been reported by other authors [18,11], who concluded that clinical diagnosis may not perceive certain difficulties in the process of swallowing. However, these studies were not conducted with robust methodologies, with standardized, constant techniques appropriate for the consistencies used.…”

Section: Discussionsupporting

confidence: 92%

Validation of Clinical Assessment for Diagnosing Dysphagia in Infants with Chronic Encephalopathy

Araújo¹

2018

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0

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Young children with chronic encephalopathy present motor and postural disorders involving several body parts due to neurological impairment, thus compromising oral motor structures. This may result in changes to the function of eating and dysphagia [1][2][3][4][5].Dysphagia is diagnosed through clinical and instrumental assessment using subjective and objective parameters in order to characterize and differentiate between normal and abnormal eating behaviour. It has been observed in clinical investigations that there is a need for an accurate diagnosis of dysphagia, with relevant information regarding the therapeutic process.Clinical assessment of swallowing is essential for recommending guidelines for safe eating without the risk of aspiration, and rehabilitation strategies [6]. However, one weakness involved in the clinical assessment of swallowing is the lack of objectivity, as it may not be possible to accurately determine any changes taking place in the phases of swallowing [6][7][8]. This may lead to doubts regarding the aspiration of food and/or saliva. Thus, it is necessary to investigate these changes through complementary methods according to each specific clinical scenario [9].

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“…The authors demonstrated a sensitivity of 92.0% for clinical assessment in the diagnosis of aspiration for liquid consistency when compared to video fluoroscopy, the latter being considered gold standard. Other authors [18] have corroborated these findings with research into children with dysphagia, aged between one month and five years. These authors demonstrated sensitivity values of above 90.0% for clinical assessment.…”

Section: Discussionmentioning

confidence: 55%

Untitled

2018

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0

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Young children with chronic encephalopathy present motor and postural disorders involving several body parts due to neurological impairment, thus compromising oral motor structures. This may result in changes to the function of eating and dysphagia [1][2][3][4][5].Dysphagia is diagnosed through clinical and instrumental assessment using subjective and objective parameters in order to characterize and differentiate between normal and abnormal eating behaviour. It has been observed in clinical investigations that there is a need for an accurate diagnosis of dysphagia, with relevant information regarding the therapeutic process.Clinical assessment of swallowing is essential for recommending guidelines for safe eating without the risk of aspiration, and rehabilitation strategies [6]. However, one weakness involved in the clinical assessment of swallowing is the lack of objectivity, as it may not be possible to accurately determine any changes taking place in the phases of swallowing [6][7][8]. This may lead to doubts regarding the aspiration of food and/or saliva. Thus, it is necessary to investigate these changes through complementary methods according to each specific clinical scenario [9].

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“…Other studies showed correlations between videofluoroscopy findings and childhood dysphagia-related clinical assessment. Santos et al indicated that the clinical evaluation of speech-language pathology had a sensitivity of 80.0%, specificity of 46.67%, a positive predictive value of 77.78%, and a negative predictive value of 77.78% for predicting dysphagia among 45 participants with cerebral palsy aged 3 -19 years (13).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Swallowing Coordination in Infants with a History of Mechanical Ventilation Longer Than 7 Days in the Neonatal Period and Assessment of Response to Oral Stimulation Maneuver

Asgarshirazi

¹

,

Shariat

²

,

Moradi

³

et al. 2023

Iran J Pediatr

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Background: Dysphagia is a frequent complication defined as difficulty in any stage of swallowing. Infants with a history of mechanical ventilation might show difficulty in coordinating pharyngeal muscles resulting in dysphagia. Objectives: The present study aimed to show the prevalence of swallowing disorders and associated symptoms among high-risk infants with a history of prolonged mechanical ventilation. Methods: A quasi-experimental study was conducted at the Breastfeeding Research Center, Tehran, Iran. All the neonates with a history of prolonged mechanical ventilation entered the study. Parents were asked to respond to a provided questionnaire regarding their infants’ swallowing disorders. Accordingly, the infants with any symptoms were considered candidates for intervention. The parents also received simple training to perform oral sensorimotor stimulation protocol for their children. Through a follow-up visit, the questionnaire was filled up for every infant. Finally, all the data related to the responses before and after interventions were compared to show the possible effects of the interventions. Results: A total of 25 infants entered the study. The mean mechanical ventilation period was 15.95 ± 6.644 days. Concerning the frequency of swallowing complications, 24 infants (96%) had different degrees of dysphagia. After 3 - 6 months of interventions, the number of cases with symptoms of coughing (P = 0.016), spitting food out by mouth (P = 0.0001), choking (P = 0.016), humid breath (P = 0.031), poor weight gain (P = 0.002), and the need to cut food into small pieces (P = 0.004) was significantly lower than the number of cases suffering from such complications before the intervention. The results also showed that after 3 - 6 months of interventions, dysphagia symptoms in 10 out of 24 infants (41.66%) entirely and in others (38.44%) partially improved. Conclusions: The results of the present study delineated that infants with a history of prolonged mechanical ventilation were at greater risk of swallowing complications. The early diagnosis and implementation of oral sensorimotor interventions could improve different symptoms of dysphagia.

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Acurácia da avaliação clínica da disfagia orofaríngea na encefalopatia crônica não progressiva

Cited by 8 publications

References 20 publications

Validation of Clinical Assessment for Diagnosing Dysphagia in Infants with Chronic Encephalopathy

Validation of Clinical Assessment for Diagnosing Dysphagia in Infants with Chronic Encephalopathy

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Evaluation of Swallowing Coordination in Infants with a History of Mechanical Ventilation Longer Than 7 Days in the Neonatal Period and Assessment of Response to Oral Stimulation Maneuver

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