Posicionamiento de la Sociedad Latinoamericana de Disfagia para el manejo de la disfagia orofaríngea y esofágica durante la pandemia COVID-19

Aquiahuatl, C Manzano; Tobar-Fredes, Rodrigo; Solares, Martín; Levy, Deborah Salle; Imamura, Rui; Fernández, R Morales; Peña, L Ojeda; Reyes, D. Parra; Santoro, Paula Freire; Ton, Valeria; Benavides, Omar Edel Trujillo; García, Miguel Antonio Vargas; Furkim, Ana Maria

doi:10.1016/j.rgmx.2021.08.002

Cited by 3 publications

(4 citation statements)

References 67 publications

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“…Durante a pandemia de COVID-19, a prática clínica fonoaudiológica necessitou de adaptações devido à implementação de medidas de precaução e segurança. Em relação aos pacientes com TQT e teste positivo para o vírus, as diretrizes iniciais não recomendavam a manipulação do cuff e a avaliação clínica da deglutição, dado o potencial risco de disseminação de aerossóis (12)(13)(14) .…”

Section: Introductionunclassified

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Atuação fonoaudiológica em pacientes traqueostomizados no contexto da COVID-19

Dias,

Santos,

Ozório

et al. 2024

Audiol., Commun. Res.

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RESUMO Objetivo Descrever as contribuições da atuação fonoaudiológica em pacientes traqueostomizados no contexto da COVID-19. Métodos Estudo retrospectivo de natureza descritiva e análise quantitativa, com coleta em prontuários de variáveis clínicas e gerais dos pacientes e dos atendimentos fonoaudiológicos. Para análise estatística, foi adotado o coeficiente de correlação de Pearson ou Spearman e nível de significância de 5% (p< 0,05). Resultados Foram incluídos 28 prontuários de pacientes (57,1% gênero masculino) com média de idade de 52 anos e 1 mês, que permaneceram internados por, aproximadamente, 53,7 dias e evoluíram para traqueostomia após 22,1 dias de intubação orotraqueal. Foram registrados dez atendimentos fonoaudiológicos por paciente, que iniciaram, em média, 38,4 dias de internação e foram solicitados em 39,3% para progressão da traqueostomia e da dieta por via oral. O cuff da traqueostomia foi mantido desinsuflado no terceiro, sugerida a decanulação em sete dias após o início e liberada dieta por via oral com cinco atendimentos. Quando analisado o tempo de início dos atendimentos fonoaudiológicos, verificou-se correlação positiva com o tempo de internação hospitalar (p<0,0001), mas não com o processo de decanulação e com o tempo de traqueostomia. Já o número de atendimentos fonoaudiológicos teve correlação positiva com o tempo de uso da traqueostomia e até a liberação da dieta por via oral. Conclusão A atuação fonoaudiológica contribuiu para reabilitação da deglutição e retorno seguro à alimentação por via oral de pacientes internados por COVID-19 e submetidos à traqueostomia.

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Section: Introductionunclassified

“…Além disso, era recomendado o adiamento dos procedimentos fonoaudiológicos até que o paciente apresentasse resultado negativo para COVID-19, ou quando os benefícios para ele superassem os riscos da intervenção (13,15) .…”

Section: Introductionunclassified

Atuação fonoaudiológica em pacientes traqueostomizados no contexto da COVID-19

Dias,

Santos,

Ozório

et al. 2024

Audiol., Commun. Res.

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“…During the COVID-19 pandemic, speech therapy clinical practice has needed to adapt due to the implementation of precautionary and safety measures. In relation to patients with a tracheostomy and a positive test for the virus, the initial guidelines did not recommend manipulating the cuff and clinically assessing swallowing, given the potential risk of spreading aerosols (12)(13)(14) .…”

Section: Introductionmentioning

confidence: 99%

“…In addition, it was recommended that speech therapy interventions be postponed until the patient tested negative for COVID-19 or when the benefits for the patient outweighed the risks of the intervention (13,15) .…”

Section: Introductionmentioning

confidence: 99%

Speech therapy performance in tracheostomized patients in the context of COVID-19

Dias,

Santos,

Ozório

et al. 2024

Audiol., Commun. Res.

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Purpose To describe the contributions of speech therapy performance in tracheostomized patients in the context of COVID-19. Methods Retrospective descriptive and quantitative analysis research, using medical records to collect clinical and general variables from patients and speech therapy interventions. For statistical analysis, the Pearson or Spearman correlation coefficient was adopted and a significance level of 5% (p< 0.05). Results Twenty-eight medical records of patients were included (57.1% male) and an average age of 52 years and 1 month, who were hospitalized for approximately 53.7 days and progressed to tracheostomy after 22.1 days of orotracheal intubation. There were ten speech therapy sessions per patient, which started on average 38.4 days into hospitalization and were requested in 39.3% of cases for the progression of tracheostomy and oral feeding. The tracheostomy cuff was kept deflated on the third intervention, decannulation was suggested seven days after the start an d the patient was given an oral diet after five interventions. When we analyzed the time speech therapy interventions began, it showed a positive correlation with the length of hospital stay (p<0.0001), but not with the decannulation process and the length of time with the tracheostomy. On the other hand, the number of speech therapy interventions had a positive correlation with the length of time the tracheostomy was in use and the time until the oral diet was released. Conclusion Speech therapy performance contributes to swallowing rehabilitation and the safe return to oral feeding in patients submitted to tracheostomy in the context of COVID-19.

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Current opinion of presentation of dysphagia and dysphonia in patients with coronavirus disease 2019

Miles

Brodsky

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewDysphagia and dysphonia are common presentations of both acute and long coronavirus disease 2019 (COVID-19). The majority of peer-reviewed publications in 2020 and early 2021 were expert guidance and consensus statements to support dysphagia management in multidisciplinary teams while protecting clinicians and patients from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. This review discusses dysphagia and dysphonia primary data published in 2021–2022, focusing on patient presentations, pathophysiology, and evidence for interventions.Recent findingsClinicians and researchers amassed knowledge of the cross-system presentation of dysphagia and dysphonia in patients with COVID-19, from severe disease requiring ICU stays to those with mild-to-moderate disease presenting to outpatient clinics. Pre-COVID-19 health status, hospitalization experience, presence of neurological symptoms, and impact of the virus to the upper aerodigestive and respiratory system need consideration in patient management. Long-term dysphagia and dysphonia manifested from COVID-19 require otolaryngologist and speech-language pathologist input.SummaryChanges in immunity through population vaccination and variations in COVID-19 from SARS-CoV-2 mutations means prevalence data are challenging to interpret. However, there is no doubt of the presence of long-term dysphagia and dysphonia in our clinics. Long-term dysphagia and dysphonia are complex and a multidisciplinary team with a tailored approach for each patient is required.

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Posicionamiento de la Sociedad Latinoamericana de Disfagia para el manejo de la disfagia orofaríngea y esofágica durante la pandemia COVID-19

Cited by 3 publications

References 67 publications

Atuação fonoaudiológica em pacientes traqueostomizados no contexto da COVID-19

Atuação fonoaudiológica em pacientes traqueostomizados no contexto da COVID-19

Speech therapy performance in tracheostomized patients in the context of COVID-19

Current opinion of presentation of dysphagia and dysphonia in patients with coronavirus disease 2019

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