SWALLOWING IN TRACHEOSTOMIZED PATIENTS ON MECHANICAL VENTILATION AFTER HEART SURGERY

Ano: 2013 | Volume: 17 | Número: Suplemento

Autores: Saconato M, Fiorese AC, Chiari BM, Corder HM, Gonçalves MIR, Gomes NAS, et al.

Resumo Inglês:

OBJECTIVE: To evaluate the swallowing function of tracheostomized patients on mechanical ventilation (MV) after heart surgery. CASE REPORT: In this study, the medical records of 10 patients (5 men and 5 women; median age, approximately 53 years) were analyzed. Out of these 10 patients, 80% (8) had undergone mitral valve replacement while the remaining 20% (2) had an aortic aneurysm correction. All patients showed prolonged OTI were tracheostomized and dependent on MV. A structural evaluation of the oral motor sensory system (OMSS) was performed as well as a functional evaluation under MV within minimal parameters; 5 ml, 10 ml, and 20 ml of pasty, thickened liquid and non-thickened liquid was offered. The following responses were assessed: oral uptake, oral motor control, oral transit time, triggering of the swallowing reflex, stasis, and laryngeal elevation. Finally, tracheal suctioning was performed. In total, 70% (7) of the patients could swallow normally the pasty diet and the non-thickened liquid under MV and 30% (3) showed moderate dysphagia for all consistencies. Among those patients, 33.4% had variations in tongue strength and ejection and 66.6% had prejudiced laryngeal elevation. In dysphagic patients, the nasoenteric tube was maintained while direct and indirect therapy was initiated. CONCLUSION: The process of evaluating patients based on MV demands precaution as glottal closure may be uncoordinated during swallowing. However, some patients on MV do not show any OMSS alteration and are not dysphagic. Therefore, their diet can be more varied and their quality of life improved.