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首页> 外文期刊>Brazilian Journal of Otorhinolaryngology >Predictive factors for oropharyngeal dysphagia after prolonged orotracheal intubation ☆
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Predictive factors for oropharyngeal dysphagia after prolonged orotracheal intubation ☆

机译：长期经口气管插管后口咽吞咽困难的预测因素☆

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Introduction: Lesions in the oral cavity, pharynx and larynx due to endotracheal intubation can cause reduction in the local motility and sensitivity, impairing the swallowing process, resulting in oropharyngeal dysphagia. Objective: To verify the predictive factors for the development of oropharyngeal dysphagia and the risk of aspiration in patients with prolonged orotracheal intubation admitted to an intensive care unit. Methods: This is an observational, analytical, cross-sectional and retrospective data collection study of 181 electronic medical records of patients submitted to prolonged orotracheal intubation. Data on age; gender; underlying disease; associated comorbidities; time and reason for orotracheal intubation; Glasgow scale on the day of the Speech Therapist assessment; comprehension; vocal quality; presence and severity of dysphagia; risk of bronchoaspiration; and the suggested oral route were collected. The data were analyzed through logistic regression. The level of significance was set at 5%, with a 95% Confidence Interval. Results: The prevalence of dysphagia in this study was 35.9% and the risk of aspiration was 24.9%. As the age increased, the altered vocal quality and the degree of voice impairment increased the risk of the presence of dysphagia by 5-; 45.4- and 6.7-fold, respectively, and of aspiration by 6-; 36.4- and 4.8-fold. The increase in the time of orotracheal intubation increased the risk of aspiration by 5.5-fold. Conclusion: Patients submitted to prolonged intubation who have risk factors associated with dysphagia and aspiration should be submitted to an early speech-language/audiology assessment and receive appropriate and timely treatment. The recognition of these predictive factors by the entire multidisciplinary team can minimize the possibility of clinical complications inherent to the risk of dysphagia and aspiration in extubated patients.
机译：简介：气管插管引起的口腔，咽和喉部病变可导致局部运动和敏感性降低，吞咽过程受损，从而导致口咽吞咽困难。目的：验证重症监护病房长期口气管插管患者口咽吞咽困难发展和误吸风险的预测因素。方法：这是一项观察性，分析性，横断面和回顾性数据收集研究，研究对象为长期经气管插管的181例电子病历。年龄数据;性别;原发疾病;相关合并症;经口气管插管的时间和原因;语言治疗师评估当天的格拉斯哥量表;理解;声音质量;吞咽困难的存在和严重程度;支气管吸入风险;并收集了建议的口服途径。通过逻辑回归分析数据。显着性水平设置为5％，置信区间为95％。结果：该研究中吞咽困难的患病率为35.9％，发生误吸的风险为24.9％。随着年龄的增长，声音质量的改变和声音障碍的程度使吞咽困难的风险增加了5;分别是抽吸的45.4和6.7倍，抽吸是6-; 36.4倍和4.8倍经口气管插管时间的增加使误吸的风险增加了5.5倍。结论：长时间插管并有吞咽困难和误吸相关危险因素的患者应接受早期言语/听觉评估，并接受适当及时的治疗。整个多学科团队对这些预测因素的认可可以使拔管患者吞咽困难和吞咽风险所固有的临床并发症的可能性降至最低。

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