Efficacy of Speech Therapy in Postintubated Patients with Oropharyngeal Dysphagia

Introduction: The intubation (orotracheal intubation) is used in the intensive care unit in critically ill patients. When extended is considered one of the main risk factors for oropharyngeal dysphagia (OPD).

Objective: The objective of this study was to evaluate the effectiveness of speech treatment in patients with OPD postintubated and without neurological comorbidities.

Methodology: Study was approved by the Research Ethics Committee of the Hospital de Clinicas de Porto Alegre (09-617). In this study, 240 patients, 40 (16.6%) were evaluated with OPD; 32 patients were included. For inclusion in the study, patients had to have received OTI for a period longer than 48 hours, have aged ≥18 years, present clinical stability. Patients were randomized into two groups: treatment and control; the monitoring occurred during 10 days for all patients. The end points were time spent with nasoenteric tube (NET) and levels of Functional Oral Intake Scale (FOIS).

Results: The treatment group needed less time with NET (median 3 days) compared to the control group (median 10 days) (p < 0.001). In the control group, there were twice as many subjects with the use of NET by OPD the end of the time speech therapist. The treated group showed a significant increase in the levels of FOIS (between 4 and 7) compared to control (p = 0.005).

Conclusions: Our findings demonstrate that speech treatment favors a more rapid progression of the NET feeding to oral feeding in postintubated patients, as well as favorable trend in functional oral intake.

Keywords: Speech therapy, deglutition disorders, intubation.