title: Swallowing rehabilitation of dysphagic tracheostomized patients under mechanical ventilation in intensive care units: a feasibility study.
abstract: OBJECTIVE
  The aim of the present study was to assess the feasibility of the early implementation of a swallowing rehabilitation program in tracheostomized patients under mechanical ventilation with dysphagia.
  
  
  METHODS
  This prospective study was conducted in the intensive care units of a university hospital. We included hemodynamically stable patients under mechanical ventilation for at least 48 hours following 48 hours of tracheostomy and with an appropriate level of consciousness. The exclusion criteria were previous surgery in the oral cavity, pharynx, larynx and/or esophagus, the presence of degenerative diseases or a past history of oropharyngeal dysphagia. All patients were submitted to a swallowing rehabilitation program. An oropharyngeal structural score, a swallowing functional score and an otorhinolaryngological structural and functional score were determined before and after swallowing therapy.
  
  
  RESULTS
  We included 14 patients. The mean duration of the rehabilitation program was 12.4 ± 9.4 days, with 5.0 ± 5.2 days under mechanical ventilation. Eleven patients could receive oral feeding while still in the intensive care unit after 4 (2 - 13) days of therapy. All scores significantly improved after therapy.
  
  
  CONCLUSIONS
  In this small group of patients, we demonstrated that the early implementation of a swallowing rehabilitation program is feasible even in patients under mechanical ventilation.
authors.affiliation: Departamento de Fonoaudiologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: Katia Alonso
authors.initials: KA
authors.lastname: Rodrigues
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: Flávia Ribeiro
authors.initials: FR
authors.lastname: Machado
authors.affiliation: Departamento de Fonoaudiologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: Brasília Maria
authors.initials: BM
authors.lastname: Chiari
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: Heloísa Baccaro
authors.initials: HB
authors.lastname: Rosseti
authors.affiliation: Departamento de Otorrinolaringologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: Paula
authors.initials: P
authors.lastname: Lorenzon
authors.affiliation: Departamento de Fonoaudiologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: Maria Inês Rebelo
authors.initials: MI
authors.lastname: Gonçalves
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000534:rehabilitation*; D005240:Feasibility Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial; D014139:Tracheostomy; D055815:Young Adult