Pneumonia aspirativa associada a alterações da deglutição: relato de caso

Junior, Carlos Toufen; Camargo, Fernanda Sartori de; Carvalho, Carlos Roberto Ribeiro de

doi:10.1590/s0103-507x2007000100016

Cited by 12 publications

(6 citation statements)

References 7 publications

(9 reference statements)

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“…In the present study, the ICU assumed the position of predominance among the other sectors, regarding the greater urgency in the use of signs indicating the risk of bronchoaspiration, corroborating with the scientific findings, which indicate a high risk of bronchoaspiration and aspiration pneumonia in patients under intensive care 19,28 . This result may also justify the prevalence of severe dysphagia in the patients of the present study, since these presented aggravating multi-factors for the risk of bronchoaspiration 29 , such as the underlying disease itself and the presence of orotracheal tube.…”

Section: Discussionsupporting

confidence: 88%

Management of the risk of bronchoaspiration in patients with oropharyngeal dysphagia

et al. 2018

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Objective: to manage the risk of bronchoaspiration in patients with oropharyngeal dysphagia through signalizing plates in the hospital bed. Methods: a descriptive, quantitative study, developed in the medical clinic I (diagnostic investigation), medical clinic II (infectology / pneumology), surgical clinics and intensive care unit of the University Hospital of the Federal University of Sergipe, from February to August 2017. It was composed of patients in the age group ≥ 18 years of age, of both sexes, diagnosed with oropharyngeal dysphagia, based on the application of the adapted protocol of clinical evaluation in the hospital bed and instrumental examination of swallowing, when pertinent. Following the clinical evaluation and identification of the risk of bronchoaspiration due to oropharyngeal dysphagia, the signs were inserted at the hospital bed by the speech therapist. Results: the study included 43 patients at risk of bronchoaspiration due to oropharyngeal dysphagia, average age of 53.7 ± 3.53 years old, with 51.1% (n = 22) females and 48.9% (n = 21) males. A predominance of neuropathies (53.4%) and severe neurogenic oropharyngeal dysphagia (37.2%) was observed. The intensive care unit stood out with 44.18% (n = 19) of the application of signs of risk of bronchoaspiration. Conclusion: the management of bronchoaspiration risk has been shown to be a promising measure to reduce adverse events, which affect the patient's safety and consequently the quality of care in the hospital environment, as well as a possible strategy for measuring respiratory complications triggered by aspiration of oropharyngeal contents.

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“…Patients with dysphagia may present complications such as impaired nutritional status, dehydration, and pulmonary infections 6 . The rate of aspiration pneumonia in these patients is high and the chance of death is 3 times higher than that in patients without dysphagia 10 .…”

Section: Introductionmentioning

confidence: 80%

Clinical findings of speech therapy swallowing assessments in patients with oropharyngeal dysphagia following orotracheal intubation

Vizioli

Balzan

Dornelles

et al. 2021

CBR

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Introduction: Endotracheal intubation has been associated with oropharyngeal dysphagia. The aim of this study was to identify the prevalence of oropharyngeal dysphagia among patients in an intensive care unit (ICU) by comparing patients requiring orotracheal intubation with those who did not undergo this procedure.Methods: This is a cross-sectional study that analyzed the medical records of 681 patients admitted to the ICU of Hospital de Clínicas de Porto Alegre between 2014 and 2017; inclusion criteria were patients aged 18 years and older who had been assessed by the hospital's Speech Therapy Service. Patients who had undergone tracheostomy, who had incomplete medical records or multiple speech-language assessments were excluded.Results: A total of 380 patients were included in the statistical analysis: 97 (25.5%) had not undergone orotracheal intubation (Group 1), 229 (60.3%) had undergone orotracheal intubation once (Group 2), and 54 (14.2%) had undergone orotracheal intubation on 2 or more occasions (Group 3). Regarding the Functional Oral Intake Scale (FOIS), 61.1% of patients in Group 3 received a FOIS I classification (p = 0.020), whereas 16.5% of patients from Group 1 received a FOIS V. Concerning their outcomes, 40.7% of patients in Group 3 died (p = 0.006), and 82.5% of patients in Group 1 were discharged from the ICU. Considering the severity of oropharyngeal dysphagia according to the Dysphagia Risk Evaluation Protocol (PARD), no statistically significant association was observed between groups (p = 0.261). Conclusions:In this study, the prevalence of oropharyngeal dysphagia was higher in patients who had undergone orotracheal intubation in the ICU.

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“…The diagnosis of BCP was present in 27% of studied cases, and there was an association between this finding and dysphagia. The association between dysphagia and BCP was already reported; however, the literature presents controversial data regarding the relation between tracheal aspiration and altered pulmonary health [40][41][42][43] . In 2016, it was identified that most cases of pneumonia among the elderly were by aspiration.…”

Section: Discussionmentioning

confidence: 98%

Profile of patients using nasoenteric probe at the adult emergency service in a public hospital

Almeida¹,

Mahmud²,

Finard³

2018

Clin. Biomed. Res.

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Introduction: Part of the prognosis of hospitalized patient depends on nutritional status and the safety and efficacy of the feeding administration route. Therefore, the aim of this study was to identify data on the indication of nasoenteric tube (NET) prescription to analyze the profile of these patients. Methods: A retrospective cross-sectional study was carried out with data collection in medical records of patients over 18 years of age, of both sexes, treated at the Emergency Adult Service (EAS), using NET. Results: there was a predominance of females (51.9%); neurological disease was the most prevalent underlying disease, and 57.8% had more than one diagnosed disease. Malnutrition, bronchopneumonia, and dysphagia were present in 23.6%, 27% and 40% of the cases, respectively. There was a request for speech-language evaluation in only 8.7% of the patients. And 80.7% did not use NET prior to emergency care. Regarding the indications for the use of NET by group of underlying disease, low food intake was the most prevalent clinical reason described in the medical records, followed by dysphagia, with a higher prevalence of patients taking NET for nutritional reasons. There was no justification for prescription in 15.2% of the sample. There was an association between the variables bronchopneumonia and dysphagia (p = 0.01). Conclusion: It was verified that in the studied population there are risk factors for dysphagia. The analysis of the population profile in the present study contributed to increased knowledge and information about this population regarding the criteria for indication of the use of the alternative route.

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“…Os cinco (33,3%) doentes que realizaram maior número de sessões, mantiveram-se nas mesmas condições anteriores à terapia sem qualquer melhoria ou piora. Foram os mesmos doentes que apresentaram piora do quadro clínico, rebaixamento de consciência ou que apresentavam dependência respiratória em algum grau 12 . Na literatura tem sido descrito que as condições respiratórias deficitárias são consideradas risco para a presença de permeabilização das vias aéreas o que pode complicar a reabilitação dos doentes com disfagia 12 .…”

Section: Discussionunclassified

Factores de risco para a progressão da ingestão alimentares por via oral de doentes com doenças neurológicas degenerativas em acompanhamento em terapia de fala.

Nunes

Duarte²,

Palmonari³

et al. 2012

Acta Med Port

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Currently studying the speech voice therapy effectiveness in cases of oropharyngeal dysphagia has been deepened and included the variables that prevent the patient develops treatment.To study the possible risk factors for progression of food intake by mouth during the speech accompanying dysphagia in patients hospitalized with degenerative neurological diseases.Retrospective study conducted at the Department of Speech Therapy in a General Hospital from January 2007 to May 2008. Were collected 117 records of patients with oropharyngeal dysphagia, and only 15 (12.8%) were diagnosed with degenerative neurological disease, evolved with complaints of dysphagia and underwent speech therapy. We used myofunctional orofacial and vocal exercises for rehabilitation. We applied Fisher's exact test and nonparametric test Mann-statistical analysis of possible relationship with risk factors, namely clinical events during therapy and respiratory conditions of patients.Study participants were 11 (73.3%) female patients and four (26.7%) males. Ten (66.7%) patients who progressed on the ability of oral intake and had less time in therapy, 11 (73.4%) did not present any problem, two (13.3%) had worsening of symptoms and two (13.3%) had a lowered level of consciousness during the therapeutic process. Ten of 15 patients (66.7%) showed progression in the ability of oral intake according to clinical assessment (range FOIS®), five (33.3%) remained the same conditions prior to therapy and no patient had worsening oral intake.The level of consciousness and respiratory complications in this study were associated with poor prognosis for the progression of oral in speech therapy.

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“…Não é considerada como uma doença, e sim, como um sintoma de uma doença ou a consequência de uma intervenção cirúrgica, podendo levar a graves complicações, como desidratação, desnutrição, aspiração de alimentos e, até mesmo à morte 5 . As complicações associadas à aspiração são comuns em pacientes com disfagia e podem determinar grave comprometimento pulmonar, aumentando a morbidade, o tempo de internação hospitalar, os custos envolvidos e o risco de morte nestes pacientes 6 .…”

Section: Introductionunclassified

Disfagia pré-internação e sua relação com o tempo de permanência hospitalar

Giglio

Oda

Daianese

2021

PECIBES

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O acidente vascular cerebral (AVC) apresenta elevada taxa de mortalidade e sequelas incapacitantes, configurando-se como importante problema de saúde pública. Dentre os fatores associados à incapacidade no AVC, destaca-se a disfagia orofaríngea neurogênica. Motivadas pelos relatos de dificuldades na alimentação vivenciadas por pacientes antes do acometimento neurológico, este estudo investigou se a queixa prévia de disfagia dos pacientes admitidos na Unidade de AVC do Hospital Universitário Maria Aparecida Pedrossian - UFMS impactou no aumento do tempo de internação quando comparados aos pacientes sem histórico e queixa de disfagia antes da internação. Trata-se de pesquisa de campo observacional, prospectiva, longitudinal, quantitativa e qualitativa. A casuística incluiu pacientes adultos de ambos os sexos, acima de 18 anos com ou sem queixa de disfagia, que responderam à triagem onde foram levantados dados indicativos da presença ou não da disfagia antes da internação. Após avaliação fonoaudiológica e estabelecimento da escala FOIS, os pacientes foram acompanhados até o momento da alta hospitalar. A Disfagia orofaríngea (DOF) foi identificada em 80% dos pacientes avaliados neste estudo. Foi significativa a associação entre não apresentar DOF e a ausência de queixa prévia, assim como não apresentar DOF e uma pontuação de NIHSS inicial menor que 10 pontos. Não houve associação entre o tempo de internação e a presença ou ausência de queixa prévia de DOF. Conclusão: Conclui-se que a investigação sobre a queixa prévia de disfagia nos pacientes acometidos por AVC pode fornecer dados norteadores para subsidiar o fonoaudiólogo durante a avaliação funcional da deglutição, porém, isoladamente, não demonstra relação estatisticamente significativa entre apresentar queixa prévia e o tempo de permanência hospitalar. Palavras-chave: Transtornos de deglutição. Acidente vascular cerebral. Tempo de internação.

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Pneumonia aspirativa associada a alterações da deglutição: relato de caso

Cited by 12 publications

References 7 publications

Management of the risk of bronchoaspiration in patients with oropharyngeal dysphagia

Clinical findings of speech therapy swallowing assessments in patients with oropharyngeal dysphagia following orotracheal intubation

Profile of patients using nasoenteric probe at the adult emergency service in a public hospital

Factores de risco para a progressão da ingestão alimentares por via oral de doentes com doenças neurológicas degenerativas em acompanhamento em terapia de fala.

Disfagia pré-internação e sua relação com o tempo de permanência hospitalar

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