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critical care dysphagia

Wesley F Kim, Thomas Sonnanstine
BACKGROUND: Despite effectively treating obesity and its comorbidities, only a fraction of the growing obese population is evaluated for bariatric surgery. Aside from barriers including resources and social support, patients report personal experience with friends and relatives suffering poor outcomes after bariatric surgery. Rates of mortality, leaks, and strictures have decreased over the past 20 years, but few instances of gross surgeon error have been reported in the literature. Our objective is to report and demonstrate the revision of a critically shortened Roux limb in a patient with chronic nausea and dysphagia found to have a 15-cm Roux limb and briefly discuss its implications...
March 14, 2018: Obesity Surgery
Ioanna Eleni Virvidaki, Grigorios Nasios, Maria Kosmidou, Sotirios Giannopoulos, Haralampos Milionis
BACKGROUND AND PURPOSE: The presence of dysphagia and aspiration in stroke patients is associated with increased mortality and morbidity. Early recognition and management of these two conditions via reliable, minimally invasive bedside procedures before complications arise remains challenging in everyday clinical practice. This study reviews the available bedside screening tools for detecting swallowing status and aspiration risk in acute stroke by qualitatively observing reference population study design, clinical flexibility, reliability and applicability to acute-care settings...
February 28, 2018: Journal of Clinical Neurology
Angela Tedesco, Valentina Lavermicocca, Marilina Notarnicola, Luca De Francesco, Anna Rita Dellomonaco
The process of medical-healthcare technological revolution represents an advantage for the patient and for the care provider, in terms of costs and distances reduction. The telehomecare approach could be useful for monitoring the swallowing disorder in neurodegenerative diseases, preventing complications. In this study the applicability of telemedicine techniques for the monitoring of swallowing function, in patients affected by Huntington's disease (HD), was evaluated through the acquisition and analysis of the sound of swallowing...
February 2018: Recenti Progressi in Medicina
Hee Seon Park, Jung Hoi Koo, Sun Hong Song
Objective: To prospectively assess the association between impoverished sensorimotor integration of the tongue and lips and post-extubation dysphagia (PED). Methods: This cross-sectional study included non-neurologic critically ill adult patients who required endotracheal intubation and underwent videofluoroscopic swallowing study (VFSS) between October and December 2016. Participants underwent evaluation for tongue and lip performance, and oral somatosensory function...
December 2017: Annals of Rehabilitation Medicine
Martin Christensen, Michaela Trapl
Post-extubation dysphagia is a condition that is becoming a growing concern. The condition occurs in 3-62% of extubated patients and can be related to mixed aetiologies, such as neuromuscular impairment, critical illness and laryngeal damage. The risk factors for developing dysphagia in critically ill patients are under-diagnosed and perhaps underestimated. Recent studies recommend the implementation of a standardized swallowing screen to prevent aspiration and decrease pneumonia rate and mortality. The aim of this quality improvement initiative was the development of a bedside swallowing screening tool to assess effective swallowing post-endotracheal extubation...
December 28, 2017: Nursing in Critical Care
Julian Bösel
Patients admitted to the neuroscience intensive care unit (NICU) may have respiratory compromise from either central or peripheral neurological pathology, and may hence require intubation and mechanical ventilation for very diverse reasons. Liberation from invasive ventilation, that is, extubation, at the earliest possible time is a widely accepted principle in intensive care. For this, classic extubation criteria have been established in the general critical care setting, mainly targeting pulmonary function and cooperativeness of the patient...
December 2017: Seminars in Respiratory and Critical Care Medicine
Joerg C Schefold, David Berger, Patrick Zürcher, Michael Lensch, Andrea Perren, Stephan M Jakob, Ilkka Parviainen, Jukka Takala
OBJECTIVES: Swallowing disorders may be associated with adverse clinical outcomes in patients following invasive mechanical ventilation. We investigated the incidence of dysphagia, its time course, and association with clinically relevant outcomes in extubated critically ill patients. DESIGN: Prospective observational trial with systematic dysphagia screening and follow-up until 90 days or death. SETTINGS: ICU of a tertiary care academic center...
December 2017: Critical Care Medicine
Lise Birgitte Austbø Holteng, Christina Tølbøl Frøiland, Anne Corbett, Ingelin Testad
BACKGROUND: Dysphagia and dementia are conditions, which combined, can lead to complications for the person and require good nutritional care. There is very little evidence-based literature regarding nutritional care for people with dysphagia and dementia. It is clear that care staff plays a vital role, and that communication and informed decision-making are critical to the process, yet little is known regarding the use of available interventions such as texture modified food (TMF), and their acceptability and feasibility for care staff and residents...
October 2017: Annals of Palliative Medicine
Melissa A Kalarchian, Wendy C King, Michael J Devlin, Gretchen E White, Marsha D Marcus, Luis Garcia, Susan Z Yanovski, James E Mitchell
BACKGROUND: Having accurate information on bariatric surgery-related gastrointestinal (GI) symptoms is critical for patient care. OBJECTIVE: To report on surgery-related GI symptoms over the first 3 years following Roux-en-Y gastric bypass and laparoscopic adjustable gastric band. SETTING: Three academic medical centers in the United States. METHODS: As a substudy of the Longitudinal Assessment of Bariatric Surgery Consortium, 183 participants (pre-surgery median body mass index = 45...
April 4, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Joanne Murray, Rhonda Pfeiffer, Ingrid Scholten
Background Comorbidities and complications of stroke have implications for level of care and hospital resources. It is critical, therefore, that hospital morbidity data accurately reflect the prevalence of these additional diagnoses. Objective This study aimed to measure and describe the concordance between stroke clinicians/researchers and medical record coders when recording stroke and related diagnoses. Method Diagnoses recorded prospectively, according to defined criteria by a clinical research team, were compared with the coding of stroke comorbidities and complications as per the Australian Coding Standards (ACS) from the separations of 100 inpatients from three rehabilitation facilities in South Australia...
January 1, 2017: HIM Journal
J D Rollnik, J Adolphsen, J Bauer, M Bertram, J Brocke, C Dohmen, E Donauer, M Hartwich, M D Heidler, V Huge, S Klarmann, S Lorenzl, M Lück, M Mertl-Rötzer, T Mokrusch, D A Nowak, T Platz, L Riechmann, F Schlachetzki, A von Helden, C W Wallesch, D Zergiebel, M Pohl
Prolonged weaning of patients with neurological or neurosurgery disorders is associated with specific characteristics, which are taken into account by the German Society for Neurorehabilitation (DGNR) in its own guideline. The current S2k guideline of the German Society for Pneumology and Respiratory Medicine is referred to explicitly with regard to definitions (e.g., weaning and weaning failure), weaning categories, pathophysiology of weaning failure, and general weaning strategies. In early neurological and neurosurgery rehabilitation, patients with central of respiratory regulation disturbances (e...
June 2017: Der Nervenarzt
Pichet Termsarasab, Steven J Frucht
Dystonic storm is a frightening hyperkinetic movement disorder emergency. Marked, rapid exacerbation of dystonia requires prompt intervention and admission to the intensive care unit. Clinical features of dystonic storm include fever, tachycardia, tachypnea, hypertension, sweating and autonomic instability, often progressing to bulbar dysfunction with dysarthria, dysphagia and respiratory failure. It is critical to recognize early and differentiate dystonic storm from other hyperkinetic movement disorder emergencies...
2017: Journal of Clinical Movement Disorders
Rachel E Pollard, Stanley L Marks, Diane M Cheney, Cecily M Bonadio
Determining the anatomic and functional origin for dysphagia is critical for development of an appropriate therapeutic plan and determination of the prognosis. The purpose of this retrospective study was to report the quantitative and qualitative outcome of contrast videofluoroscopic swallowing studies in a large cohort of dysphagic dogs presenting to a tertiary veterinary care hospital. The videofluoroscopic swallowing studies were reviewed to generate values for pharyngeal constriction ratio, timing of swallowing events (maximum pharyngeal contraction, opening of upper esophageal sphincter, closing of upper esophageal sphincter, and reopening of epiglottis), type of esophageal peristalsis generated, and esophageal transit time...
March 23, 2017: Veterinary Radiology & Ultrasound
Cynthia R O'Donoghue, Elizabeth E Nottingham
As the number of speech-language pathologists (SLPs) responsible for swallowing and feeding services in the educational setting increases, guidance informing this specialized practice continues to emerge. Although SLPs have provided dysphagia management for children in medical settings for many years, the extension of dysphagia services to the schools is comparatively new. This shift in care delivery for what was previously a hospital-based practice is now occurring more frequently, and in an environment void of extensive medical supports (i...
April 2017: Seminars in Speech and Language
Caihong Dong, Tanyou Shan, Xiaozhi Yuan, Shuoguo Li, Xuezhen Ding, Shegan Gao
214 Background: To relieve the dysphagia is a critical treatment for advanced esophageal cancer patients' palliative care in their end-of-life. The ideal way is to satisfy both the patient's nutrition supplement and self-taste. Although several endoscopic dilation techniques have been reported, the high incidence of dysphagia quickly relapsing remains. The aim of this study was to compare the effect of Argon Plasma Coagulation (APC) combined with Savary bougienage (SB) and SB alone for the relief of dysphagia of esophageal squamous cancer in the end-of-life...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Zhongheng Zhang, Jason Akulian, Yucai Hong, Ning Liu, Yuhao Chen
Cerebrovascular accident (CVA) is commonly seen among the elderly with a substantial proportion of patients suffering from long-term dysphagia and/or an inability to protect their airway. This potentially imposes on them an increased risk of malnutrition and aspiration pneumonia. In this article, we present a patient with malnutrition and dysphagia secondary to CVA. We propose a procedure for which we will name the Percutaneous ENdoscopIc Gastrostomy and Tracheostomy (PENlIGhT) procedure for placement of percutaneous endoscopic gastrostomy (PEG) and tracheostomy tube (TT) at the same time...
December 2016: Journal of Thoracic Disease
Abby White, Raphael Bueno
Esophageal atresia is a rare congenital anomaly, but improved surgical and critical care has resulted in survival rates exceeding 90%. Long-term survival is associated with numerous management challenges including chronic motility disorders, dysphagia, strictures, reflux, esophagitis and attendant complications, tracheomalacia and chronic restrictive lung disease, and recurrent pulmonary infections. No guidelines for adolescents and younger or older adults exist for the treatment and monitoring of this specialized patient population...
March 2017: Current Treatment Options in Gastroenterology
Julie Bernhardt, Erin Godecke, Liam Johnson, Peter Langhorne
PURPOSE OF REVIEW: Early rehabilitation is recommended in many guidelines, with limited evidence to guide practice. Brain neurobiology suggests that early training, at the right dose, will aid recovery. In this review, we highlight recent trials of early mobilization, aphasia, dysphagia and upper limb treatment in which intervention is commenced within 7 days of stroke and discuss future research directions. RECENT FINDINGS: Trials in this early time window are few...
February 2017: Current Opinion in Neurology
Kay Choong See, Si Yu Peng, Jason Phua, Chew Lai Sum, Johncy Concepcion
BACKGROUND: Swallowing difficulties are common, and dysphagia occurs frequently in intensive care unit (ICU) patients after extubation. Yet, no guidelines on postextubation swallowing assessment exist. We aimed to investigate the safety and effectiveness of nurse-performed screening (NPS) for postextubation dysphagia in the medical ICU. METHODS: We conducted a retrospective cohort study of mechanically ventilated patients who were extubated in a 20-bed medical ICU...
October 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
Tamer Abdallah Helmy, Mohamed Abd-Elalim Abd-Elhady, Mohammed Abdou
BACKGROUND: Stroke is a leading cause of death and disability worldwide. Among all poststroke complications, pneumonia constitutes a major complication with a strong impact on morbidity and mortality. To identify patients at high risk of stroke-associated pneumonia (SAP) and to tailor a prophylactic approach, a reliable scoring model for prediction may be useful in daily stroke care. OBJECTIVES: This study aimed to compare the performance of the Age, Atrial fibrillation, Dysphagia, Sex, Stroke Severity (A2 DS2 ) score, the acute ischemic stroke-associated pneumonia score (AIS-APS), and the Preventive ANtibacterial THERapy in acute Ischemic Stroke (PANTHERIS) score in predicting SAP...
November 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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