Profile of deglutition speech evaluation in an intensive care unit

Objective

To characterize critically ill patients evaluated by a speech deglutition therapist.

Methods

The files of 96 patients evaluated by the speech therapy service in the ICU from July 2005 to July 2006 were analyzed, focusing on data about age, gender, main diagnosis (admission category), alternative feeding ways (presence or not), and severity of dysphagia at the moment of evaluation.

Results

From July 2005 to July 2006, 96 evaluations were performed, enabling identification of cases through 89 digitalized files. In the 89 patients, 58 (65%) were male and 31 (35%) were female, with ages varying from 14 to 96 years (average 62 years). As for the main diagnosis, we found: (1%) greatly burned, one nephrologic disorder (1%), seven (7.8%) oncologic, eight (8.9%) gastroenterologic, nine (10.1%) cardiologic, 14 (15.7%) pneumologic disorder, 23 (25.8%) post-liver transplant, and 27 (30.3%) neurologic disorder. In 89 evaluations, 72 (80%) had alternative feeding ways, (nasogastric tube, gastrostomy or parenteral nutrition) and 17 (20%) did not. According to the adapted classification of O'Neil and colleagues' scale [1] (used in our service), we found that 21 (24%) patients had functional deglutition, 34 (38.2%) mild dysphagia, six (6.7%) mild/moderate dysphagia, 13 (14.6%) moderate dysphagia, seven (7.8%) moderate/severe dysphagia, and eight (8.9%) severe dysphagia.

Conclusion

We observed that the major amount of patients requesting speech therapist evaluation in the ICU had neurologic or pneumologic origin diseases or were post-liver transplants patients (65% male patients and 80.8% with alternative feeding methods). In 68 (76.4%) of 89 cases, some degree of dysphagia was detected.

We would like to emphasize that speech deglutition evaluation contributed to identifying dysphagia and consequently was indicated to begin the rehabilitation process or to reintroduce oral feeding with safety. More findings of this analysis will be discussed further.