Características de los pacientes con alteraciones de la deglución hospitalizados en UPC con diagnóstico de SARS-CoV-2: una revisión sistemática

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Se trata de determinar las características de los pacientes con alteraciones de la deglución hospitalizados en Unidades de Paciente Crítico con diagnóstico de SARS-CoV-2 durante el periodo 2020-2021. Para este objetivo se realiza una revisión sistemática con enfoque cualitativo exploratorio. Se aplicaron estrategias de búsqueda en bases de datos PubMed, ScienceDirect, Web Of Science y Scielo. Se seleccionaron estudios en inglés, español y portugués desde el año 2020, con sujetos mayores de 18 años, hospitalizados en Unidades de Paciente Crítico con COVID-19 y disfagia. Los resultados muestran que el tiempo promedio de hospitalización de pacientes con diagnóstico SARS-CoV-2 en Unidades de Cuidado Intensivo varía entre 15 y 34 días. Respecto a las características de la vía aérea artificial, las más frecuentes son la intubación orotraqueal y la traqueostomía, donde el promedio de uso mínimo es de 10 días y el máximo de 17 días en el caso de la intubación, mientras que para la traqueostomía el mínimo y máximo es de 19 y 30 días respectivamente. La disfagia orofaríngea es frecuente en los sujetos. En los pacientes con COVID-19 y disfagia, el promedio de días de hospitalización y el promedio de uso de vía aérea artificial es mayor a lo reportado en la literatura en épocas sin pandemia. A mayor tiempo de uso de vía aérea artificial, mayor es el riesgo de adquirir una alteración de la deglución y prolongar la estadía de una Unidad de Paciente Crítico. La disfagia orofaríngea es frecuente en pacientes con SARS-CoV-2. Se recomienda continuar con investigaciones observacionales y experimentales en el área.

Related collections

Most cited references 16

Record: found
Abstract: found
Article: not found

Dysphagia in Mechanically Ventilated ICU Patients (DYnAMICS)

Joerg Schefold, David Berger, Patrick Zürcher … (2017)

Swallowing disorders may be associated with adverse clinical outcomes in patients following invasive mechanical ventilation. We investigated the incidence of dysphagia, its time course, and association with clinically relevant outcomes in extubated critically ill patients.

0 comments Cited 63 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Swallowing and voice outcomes in patients hospitalised with COVID-19: An observational cohort study

Sally K Archer, Christina M. Iezzi, Louisa Gilpin (2021)

Objective To evaluate the presentations and outcomes of inpatients with COVID-19 presenting with dysphonia and dysphagia in order to investigate trends and inform potential pathways for ongoing care. Design Observational cohort study. Setting An inner city NHS Hospital Trust in London, UK. Participants All adult inpatients hospitalised with COVID-19 who were referred to Speech and Language Therapy (SLT) for voice and/or swallowing assessment for 2 months from April 2020. Interventions SLT assessment, advice and therapy for dysphonia and dysphagia. Main Outcome Measures Evidence of delirium, neurological presentation, intubation, tracheostomy and proning history were collected, along with type of SLT provided and discharge outcomes. Therapy Outcome Measures (TOMs) were recorded for swallowing and tracheostomy pre/post SLT intervention and GRBAS for voice. Results 164 patients (104M), age 56.8±16.7y were included. Half (52.4%) had a tracheostomy, 78.7% had been intubated (mean 15±6.6days), 13.4% had new neurological impairment and 69.5% were delirious. Individualised compensatory strategies were trialled in all and direct exercises with 11%. Baseline assessments showed marked impairments in dysphagia and voice but there was significant improvement in all during the study (p<0.0001). On average patients started some oral intake 2 days after initial SLT assessment (IQR 0-8) and were eating and drinking normally on discharge but 29.3%(n=29)of those with dysphagia and 56.1% (n=37) of those with dysphonia remained impaired at hospital discharge. 70.9% tracheostomised patients were decannulated, median (IQR) time to decannulation 19 days(16-27).Across all (n=164), 37.3% completed SLT input while inpatients, 23.5% were transferred to another hospital, 17.1% had voice and 7.8% required community follow-up for dysphagia. Conclusions Inpatients with COVID-19 present with significant impairments of voice and swallowing, justifying responsive SLT. Prolonged intubations and tracheostomies were the norm and a minority had new neurological presentations. Patients typically improved with assessment that enabled treatment with individualised compensatory strategies. Services preparing for COVID-19 should target resources for tracheostomy weaning and to enable responsive management of dysphagia and dysphonia with robust referral pathways.

0 comments Cited 26 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Characterization of dysphagia and laryngeal findings in COVID-19 patients treated in the ICU—An observational clinical study

Hanna Osbeck Sandblom, Hans Dotevall, Kristina Svennerholm … (2021)

Background Dysphagia appears to be common in patients with severe COVID-19. Information about the characteristics of dysphagia and laryngeal findings in COVID-19 patients treated in the intensive care unit (ICU) is still limited. Objectives The aim of this study was to evaluate oropharyngeal swallowing function and laryngeal appearance and function in patients with severe COVID-19. Method A series of 25 ICU patients with COVID-19 and signs of dysphagia were examined with fiberendoscopic evaluation of swallowing (FEES) during the latter stage of ICU care or after discharge from the ICU. Swallowing function and laryngeal findings were assessed with standard rating scales from video recordings. Results Pooling of secretions was found in 92% of patients. Eleven patients (44%) showed signs of silent aspiration to the trachea on at least one occasion. All patients showed residue after swallowing to some degree both in the vallecula and hypopharynx. Seventy-six percent of patients had impaired vocal cord movement. Erythema of the vocal folds was found in 60% of patients and edema in the arytenoid region in 60%. Conclusion Impairment of oropharyngeal swallowing function and abnormal laryngeal findings were common in this series of patients with severe COVID-19 treated in the ICU. To avoid complications related to dysphagia in this patient group, it seems to be of great importance to evaluate the swallowing function as a standard procedure, preferably at an early stage, before initiation of oral intake. Fiberendoscopic evaluation of swallowing is preferred due to the high incidence of pooling of secretion in the hypopharynx, silent aspiration, and residuals. Further studies of the impact on swallowing function in short- and long-term in patients with COVID-19 are warranted.