Brief ReportQuantifying fluid intake in dysphagic stroke patients: A preliminary comparison of oral and nonoral strategies☆,☆☆,★,★★,♢
Section snippets
Methods
The present research was part of a prospective study investigating the energy metabolism of stroke patients. Fifty-five patients admitted to a university-affiliated hospital within 5 days of onset of symptoms of their first ischemic or hemorrhagic stroke were enrolled in the study between August 1996 and October 1997 and studied for 21 days. At admission, 28 patients (50.9%) were determined to be dysphagic on the basis of a bedside swallowing evaluation performed by a speech-language
Group 1: Stroke patients initiated on enteral feeding
In the acute stage, group 1 patients received a mean of 3158mL of fluid daily from all sources, representing 134% of their estimated fluid requirements (table 1).Intravenous therapy began on admission and continued for 7 to 9 days. In the subacute stage, the mean fluid intake of group 1 patients dropped to 984mL/d, representing 43% of their estimated fluid requirements, or approximately one third of previous values (see table 1). These patients remained on thickened fluids from 7 to 25 days
Discussion
The results of the present preliminary study suggest that dysphagic stroke patients receiving thickened-fluid dysphagia diets failed to achieve fluid intakes that meet their estimated fluid requirements, whereas enterally and intravenously fed patients exceeded theirs. Acutely dysphagic patients who were unable to eat orally were started on intravenous fluids immediately after admission and within 12 to 48 hours also received a NG tube for enteral feedings. Patients started on oral dysphagia
Conclusions
Dysphagic stroke patients on thickened-fluid dysphagic diets did not consume sufficient fluid to meet their needs and are at risk for developing dehydration and its consequences. However, enterally fed patients met or exceeded their requirements through the use of supplemental fluids given either enterally or intravenously. The findings of this preliminary study must be confirmed by a prospective study that uses a larger, randomly selected sample.
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Cited by (89)
Thirstiness, body hydration and thickened water: A study about their relationship
2023, Food Quality and PreferenceFluids, energy intake, and stroke
2023, Diet and Nutrition in Neurological DisordersFluid and energy intake in stroke patients during acute hospitalization in a stroke unit
2019, Journal of Clinical NeuroscienceCitation Excerpt :Main fluid source in patients with dysphagia depended on IVs fluids prescription accounting for 57.2% of total fluids, while water from enteral and parenteral formulas accounted only for 15.6% of the overall fluid intake. Our results are in contrast with previous findings [24], suggesting that in our sample most patients still did not receive enough fluids independently if they were receiving a “nil per os” (NOS) diet or a thickened-fluid diet. In the multivariate analysis oral fluid consumption was associated with risk of dehydration at discharge, while total fluid intake (including enteral and parenteral fluids) did not reach statistical significance.
ESPEN guideline clinical nutrition in neurology
2018, Clinical NutritionSwallowing Disorders After Stroke
2018, Stroke Rehabilitation
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Supported by the Heart and Stroke Foundation of Ontario (grant no. T-3602).
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
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Reprint requests to Hillel M. Finestone, MD, St. Vincent's Hospital, 60 Cambridge St. N, Ottawa, Ont K1R 7A5, Canada, e-mail: [email protected].
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