Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Rehabilitation Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Gyeonggi-do, Republic of Korea.
Medicine (Baltimore). 2022 Sep 23;101(38):e30600. doi: 10.1097/MD.0000000000030600.
The study aimed to investigate the status of thickener use in dysphagia patients with brain lesions and incidence of adverse events based on fluid viscosity. Twenty dysphagia patients with brain lesions who were recommended to use thickeners following a videofluoroscopic swallowing study were enrolled in this observational pilot study. Patients were educated to use thickener as level 2 or 3 based on the International Dysphagia Diet Standardization Initiative flow test. We evaluated the viscosity of the fluid that patients drank once a week for 2 weeks, and reviewed medical records regarding adverse events. Patients were divided into 2 groups based on the average value obtained from the viscosity evaluations as thin (Levels 0-2) and thick fluid groups (Levels 3-4). Adverse events were compared between the groups. The number of patients who did not follow the recommendations increased from 35.0 to 45.0% during the 1-week follow-up period. No patient developed pneumonia or urinary tract infection. Constipation (P = 0.338) and dehydration status (P = 0.202) were not significantly different between the 2 groups. In 2 evaluations for 20 patients, 40.0% of the cases did not follow the educated viscosity, and the number gradually increased in the follow-up evaluation. Considering that there were no significant differences in the incidence of adverse effects including pneumonia according to the fluid viscosity, a further study is necessary to establish detailed criteria for thickener use in dysphagia patients with brain lesions.
本研究旨在调查基于液体黏度的脑损伤吞咽障碍患者增稠剂使用现状和不良事件发生率。20 名经视频透视吞咽研究推荐使用增稠剂的脑损伤吞咽障碍患者参与了这项观察性初步研究。根据国际吞咽障碍饮食标准化倡议（IDDSI）流动测试，患者被教育使用 2 级或 3 级增稠剂。我们每周评估患者饮用的液体黏度 1 次，共 2 周，并回顾医疗记录中的不良事件。根据黏度评估的平均值，将患者分为稀薄组（0-2 级）和浓稠组（3-4 级）。比较两组间的不良事件。在 1 周的随访期间，不遵守建议的患者比例从 35.0%增加到 45.0%。无患者发生肺炎或尿路感染。两组间便秘（P = 0.338）和脱水状态（P = 0.202）无显著差异。在 20 名患者的 40.0%的 40 次评估中，未遵循所教育的黏度，且在随访评估中逐渐增加。考虑到根据液体黏度，肺炎等不良影响的发生率无显著差异，需要进一步研究以制定脑损伤吞咽障碍患者增稠剂使用的详细标准。
