Functional development of swallowing in ICU patients with COVID-19

Lima, Maíra Santilli de; Sassi, Fernanda Chiarion; Medeiros, Gisele Chagas de; Ritto, Ana Paula; Andrade, Claudia Regina Furquim de

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Sumário

Brief Communication • CoDAS 32 (4) • 2020 • https://doi.org/10.1590/2317-1782/20192020222 copy

Functional development of swallowing in ICU patients with COVID-19

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

to describe de functional development of swallowing in Intensive Care Unit (ICU) patients with COVID-19, who were submitted to a swallowing intervention.

Methods

participants of the study were 77 patients (both gender, mean age 53.4±15.9; score on the Glasgow Coma Scale ≥14 and stable respiratory condition). The functional scale of swallowing used for assessment was the American Speech-Language-Hearing Association National Outcome Measurement System (ASHA NOMS).

Results

the results indicate that there was a significant recovery of the functional swallowing patterns when comparing the measurements pre and post swallowing intervention.

Conclusion

83% of the patients needed up to 3 swallowing interventions to recover a safe swallowing pattern.

Keywords
Swallowing; Swallowing Disorders; Intensive Care Units; COVID-19; Speech-Language and Hearing Science

Level	Definition	Initial Result		Final Result		p-value
Level	Definition	Number of cases	Total in each level	Number of cases	Total in each level	p-value
Level 1 and 2	The individual is not able to swallow anything safely by mouth. Almost all nutrition and hydration are received by an alternative method of feeding (eg: nasogastric tube, gastrostomy).	7	9.1%	0	0	<0.001*
Level 3	Alternative method of feeding is necessary, since the individual ingests less than 50% of the nutrition and hydration through the mouth; and/or swallowing is safe with the moderate use of clues to use compensatory strategies; and/or requires maximum diet restriction.	7	9.1%	0	0	<0.001*
Level 4	Swallowing is safe, but often requires moderate use of clues to use compensatory strategies; and/or the individual has moderate dietary restrictions; and/or still need tube feeding and/or oral supplement.	22	28.6%	1	1.3%	<0.001*
Level 5	Swallowing is safe with minimal dietary restrictions; and/or occasionally requires minimal leads to use compensatory strategies. You can occasionally monitor yourself. All nutrition and hydration are received by the mouth during the meal.	21	27.3%	5	6.5%	0.001*
Level 6	Swallowing is safe and the individual eats and drinks independently. It rarely requires minimal clues to use compensatory strategies. It is often self-monitoring when difficulties occur. It may be necessary to avoid certain specific food items (eg, popcorn and peanuts); additional time for feeding may be necessary (due to dysphagia).	9	11.7%	18	23.4%	0.020*
Level 7	The individual's ability to feed independently is not limited by the swallowing function. Swallowing is safe and efficient for all consistencies. Compensatory strategies are used effectively when necessary.	11	14.3%	53	68.8%	0.016*

		Total number of participants (percentage)
Number of treatment units until the patient is allowed for oral administration	1	16 (20.8%)
	2	21 (27.3%)
	3	19 (24.7%)
	4	8 (10.4%)
	5	7 (9.1%)
	6	1 (1.3%)
	7	4 (5.2%)
	8	0 (0.0%)
	9	1 (1.3%)

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[1] Conflict of interests: nothing to declare.