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Clinical screening of oropharyngeal dysphagia: standard of care
European Respiratory Journal ( IF 16.6 ) Pub Date : 2017-08-01 , DOI: 10.1183/13993003.01030-2017
Ivan Caviedes , Sebastian Fernandez-Bussy , Gonzalo Labarca , Felix J.F. Herth

We read with interest the paper by Verin et al. [1] related to oropharyngeal dysphagia and its importance in institutionalised neurological and head and neck patients, between others. Furthermore, this is a very common problem in the critical and intermediate care settings, and a similar situation occurs with other acute neurological diseases, such as amyotrophic lateral sclerosis, cerebral trauma, post-neurosurgical procedures and toxic metabolic encephalopathies [2, 3]. The authors emphasised the necessity of identifying risks factors for aspiration early and suggested that clinical screening methods are needed to recognise patients with oropharyngeal dysphagia. However, swallowing clinical screening performed by speech therapists and nurses is a standard of care in critical care units. This concept is particularly relevant, considering that in stroke patients, the prognosis is closely related to the medical complications, and aspiration is responsible for >50% of these and increases mortality for up to 33% at 6 months. Even more, after the acute phase of a stroke, swallowing dysfunction has a recovery capacity of 87% at 6 months [4–6]. The three-ounce water test is a well-known and useful bedside screening tool for oropharyngeal dysphagia http://ow.ly/9Krl30cW2HJ

中文翻译:

口咽部吞咽困难的临床筛查:护理标准

我们饶有兴趣地阅读了 Verin 等人的论文。[1] 与口咽吞咽困难及其在机构化神经系统和头颈部患者中的重要性等相关。此外,这是重症和中级护理环境中非常常见的问题,类似的情况也发生在其他急性神经系统疾病中,例如肌萎缩侧索硬化、脑外伤、神经外科手术后和中毒性代谢性脑病 [2, 3]。作者强调了早期识别误吸危险因素的必要性,并建议需要临床筛查方法来识别口咽吞咽困难的患者。然而,由语言治疗师和护士进行的吞咽临床筛查是重症监护病房的标准护理。这个概念特别相关,考虑到卒中患者的预后与医学并发症密切相关,误吸占其中的 50% 以上,6 个月时死亡率高达 33%。更重要的是,在卒中急性期后,吞咽功能障碍在 6 个月内的恢复能力为 87% [4-6]。三盎司水测试是众所周知的有用的口咽吞咽困难的床边筛查工具 http://ow.ly/9Krl30cW2HJ
更新日期:2017-08-01
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