Oropharyngeal Dysphagia and Impaired Motility of the Upper Gastrointestinal Tract—Is There a Clinical Link in Neurocritical Care?

Patients in the neurological ICU are at risk of suffering from disorders of the upper gastrointestinal tract. Oropharyngeal dysphagia (OD) can be caused by the underlying neurological disease and/or ICU treatment itself. The latter was also identified as a risk factor for gastrointestinal dysmotilit...

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Autores principales:	Paul Muhle, Karen Konert, Sonja Suntrup-Krueger, Inga Claus, Bendix Labeit, Mao Ogawa, Tobias Warnecke, Rainer Wirth, Rainer Dziewas
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	gastric residual volume dysphagia flexible endoscopic evaluation of swallowing gastric emptying intensive care neurology Nutrition. Foods and food supply TX341-641
Acceso en línea:	https://doaj.org/article/3327088331244b73af77fffca270d9d2
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spelling	oai:doaj.org-article:3327088331244b73af77fffca270d9d22021-11-25T18:34:53ZOropharyngeal Dysphagia and Impaired Motility of the Upper Gastrointestinal Tract—Is There a Clinical Link in Neurocritical Care?10.3390/nu131138792072-6643https://doaj.org/article/3327088331244b73af77fffca270d9d22021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6643/13/11/3879https://doaj.org/toc/2072-6643Patients in the neurological ICU are at risk of suffering from disorders of the upper gastrointestinal tract. Oropharyngeal dysphagia (OD) can be caused by the underlying neurological disease and/or ICU treatment itself. The latter was also identified as a risk factor for gastrointestinal dysmotility. However, its association with OD and the impact of the neurological condition is unclear. Here, we investigated a possible link between OD and gastric residual volume (GRV) in patients in the neurological ICU. In this retrospective single-center study, patients with an episode of mechanical ventilation (MV) admitted to the neurological ICU due to an acute neurological disease or acute deterioration of a chronic neurological condition from 2011–2017 were included. The patients were submitted to an endoscopic swallowing evaluation within 72 h of the completion of MV. Their GRV was assessed daily. Patients with ≥1 d of GRV ≥500 mL were compared to all the other patients. Regression analysis was performed to identify the predictors of GRV ≥500 mL/d. With respect to GRV, the groups were compared depending on their FEES scores (0–3). A total of 976 patients were included in this study. A total of 35% demonstrated a GRV of ≥500 mL/d at least once. The significant predictors of relevant GRV were age, male gender, infratentorial or hemorrhagic stroke, prolonged MV and poor swallowing function. The patients with the poorest swallowing function presented a GRV of ≥500 mL/d significantly more often than the patients who scored the best. Conclusions: Our findings indicate an association between dysphagia severity and delayed gastric emptying in critically ill neurologic patients. This may partly be due to lesions in the swallowing and gastric network.Paul MuhleKaren KonertSonja Suntrup-KruegerInga ClausBendix LabeitMao OgawaTobias WarneckeRainer WirthRainer DziewasMDPI AGarticlegastric residual volumedysphagiaflexible endoscopic evaluation of swallowinggastric emptyingintensive careneurologyNutrition. Foods and food supplyTX341-641ENNutrients, Vol 13, Iss 3879, p 3879 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	gastric residual volume dysphagia flexible endoscopic evaluation of swallowing gastric emptying intensive care neurology Nutrition. Foods and food supply TX341-641
spellingShingle	gastric residual volume dysphagia flexible endoscopic evaluation of swallowing gastric emptying intensive care neurology Nutrition. Foods and food supply TX341-641 Paul Muhle Karen Konert Sonja Suntrup-Krueger Inga Claus Bendix Labeit Mao Ogawa Tobias Warnecke Rainer Wirth Rainer Dziewas Oropharyngeal Dysphagia and Impaired Motility of the Upper Gastrointestinal Tract—Is There a Clinical Link in Neurocritical Care?
description	Patients in the neurological ICU are at risk of suffering from disorders of the upper gastrointestinal tract. Oropharyngeal dysphagia (OD) can be caused by the underlying neurological disease and/or ICU treatment itself. The latter was also identified as a risk factor for gastrointestinal dysmotility. However, its association with OD and the impact of the neurological condition is unclear. Here, we investigated a possible link between OD and gastric residual volume (GRV) in patients in the neurological ICU. In this retrospective single-center study, patients with an episode of mechanical ventilation (MV) admitted to the neurological ICU due to an acute neurological disease or acute deterioration of a chronic neurological condition from 2011–2017 were included. The patients were submitted to an endoscopic swallowing evaluation within 72 h of the completion of MV. Their GRV was assessed daily. Patients with ≥1 d of GRV ≥500 mL were compared to all the other patients. Regression analysis was performed to identify the predictors of GRV ≥500 mL/d. With respect to GRV, the groups were compared depending on their FEES scores (0–3). A total of 976 patients were included in this study. A total of 35% demonstrated a GRV of ≥500 mL/d at least once. The significant predictors of relevant GRV were age, male gender, infratentorial or hemorrhagic stroke, prolonged MV and poor swallowing function. The patients with the poorest swallowing function presented a GRV of ≥500 mL/d significantly more often than the patients who scored the best. Conclusions: Our findings indicate an association between dysphagia severity and delayed gastric emptying in critically ill neurologic patients. This may partly be due to lesions in the swallowing and gastric network.
format	article
author	Paul Muhle Karen Konert Sonja Suntrup-Krueger Inga Claus Bendix Labeit Mao Ogawa Tobias Warnecke Rainer Wirth Rainer Dziewas
author_facet	Paul Muhle Karen Konert Sonja Suntrup-Krueger Inga Claus Bendix Labeit Mao Ogawa Tobias Warnecke Rainer Wirth Rainer Dziewas
author_sort	Paul Muhle
title	Oropharyngeal Dysphagia and Impaired Motility of the Upper Gastrointestinal Tract—Is There a Clinical Link in Neurocritical Care?
title_short	Oropharyngeal Dysphagia and Impaired Motility of the Upper Gastrointestinal Tract—Is There a Clinical Link in Neurocritical Care?
title_full	Oropharyngeal Dysphagia and Impaired Motility of the Upper Gastrointestinal Tract—Is There a Clinical Link in Neurocritical Care?
title_fullStr	Oropharyngeal Dysphagia and Impaired Motility of the Upper Gastrointestinal Tract—Is There a Clinical Link in Neurocritical Care?
title_full_unstemmed	Oropharyngeal Dysphagia and Impaired Motility of the Upper Gastrointestinal Tract—Is There a Clinical Link in Neurocritical Care?
title_sort	oropharyngeal dysphagia and impaired motility of the upper gastrointestinal tract—is there a clinical link in neurocritical care?
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/3327088331244b73af77fffca270d9d2
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Oropharyngeal Dysphagia and Impaired Motility of the Upper Gastrointestinal Tract—Is There a Clinical Link in Neurocritical Care?

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