title: Clinical swallowing assessment in intensive care unit.
abstract: OBJECTIVE
  To report the results of the full clinical swallowing assessment in acute-care population in a large Brazilian teaching hospital.
  
  
  METHODS
  A prospective, descriptive clinical study was conducted during three months in a 30-bed adult clinical emergency ICU from a large Brazilian teaching hospital. Thirty-five patients consecutively referred to the Speech-Language Pathology Service according to our standard clinical practice were included. A full clinical swallowing assessment was completed and includes a Preliminary Assessment Protocol (PAP), a Dysphagia Risk Evaluation Protocol (DREP) and an Oral Feeding Transition Protocol (OFTP).
  
  
  RESULTS
  In this study, the prevalence of OD in the ICU setting was of 63%, most of which were classified as moderate and moderate-severe (39%). Patients submitted to orotracheal intubation were very frequently referred to swallowing assessment (74%). The results of the statistical analyses revealed clinical indicators that could correctly classify patients as either having or not having OD on clinical tests. These include cough strength, coordination between breathing and speaking, dysphonia severity, and laryngeal elevation. Twenty six patients (74%) completed all protocols. Of these total, 38% were able to eat a regular diet.
  
  
  CONCLUSIONS
  The practice with standardized protocols adds an important option for the management of oropharyngeal dysphagia in intensive care unit.
authors.forename: Aline Rodrigues
authors.initials: AR
authors.lastname: Padovani
authors.forename: Danielle Pedroni
authors.initials: DP
authors.lastname: Moraes
authors.forename: Fernanda Chiarion
authors.initials: FC
authors.lastname: Sassi
authors.forename: Claudia Regina Furquim de
authors.initials: CR
authors.lastname: Andrade
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002985:Clinical Protocols; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D004032:Diet; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D013066:Speech-Language Pathology / Q000379:methods