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Year: 2013  Vol. 17   Num. Suppl. 1  - Print:
SWALLOWING IN TRACHEOSTOMIZED PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT OF PNEUMOLOGY
Author(s):
Mariana Saconato, Ana Carolina Fiorese, Brasilia Maria Chiari, Helena Menegon Corder, Maria Inês Rebelo Gonçalves, Nathaly Anne de Souza Gomes
Abstract:

OBJECTIVE: To evaluate the swallowing function of tracheostomized patients in the intensive care unit (ICU) of Pneumology. CASE REPORT: In this study, the medical records of 10 individuals (6 men and 4 women; mean age, approximately 55 years) were analyzed. These individuals were tracheostomized in the ICU of Pneumology. Out of these 10 individuals, 50% (5) had chronic obstructive pulmonary disorder (COPD), 10% (1) tuberculosis, 10% (1) myasthenia gravis (MG), 1 (10%) acute respiratory distress syndrome (ARDS), 1 (10%) acute immunodeficiency syndrome (AIDS), and 10% (1) had undergone a pneumonectomy. On structural evaluation, the oral motor sensory system was found to be abnormal in patients with MG and ARDS; 5 ml, 10 ml, and 20 ml of pasty, thickened liquid and non-thickened liquid was required. The cuff had to remain inflated in the COPD and AIDS patients to limit saturation. These patients were not dysphagic, and oral feeding with a non-thickened, pasty liquid was allowed on the second day of treatment. In 2 dysphagia patients (those with MG and AIDS), direct and indirect therapy was necessary, with an average of 15 sessions for oral feeding with the cuff inflated. In the patients who had undergone pneumonectomy, oral feeding was allowed with the use of a Passy-Muir speaking valve after 3 days of therapy. CONCLUSION: Prolonged OTI and tracheostomy are common in the treatment of many pulmonary diseases. In patients who had difficulty with ventilation weaning and cuff deflation, evaluation of their swallowing function is necessary to verify the ideal and safe requirements for feeding these patients whilst in or outside the, always with an inflated cuff, while will improve their quality of life and facilitate recovery.

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