title: Swallowing Disorders in Severe Brain Injury in the Arousal Phase.
abstract: The objective of this study was to determine the clinical characteristics of swallowing disorders in severe brain injury in the arousal phase after coma. Between December 1, 2013 and June 30, 2014, eleven patients with severe acquired brain injury who were admitted to rehabilitation center (Male 81.8 %; 40.7 ± 14.6 years) were included in the study. Evaluation of swallowing included a functional examination, clinical functional swallowing test, and naso-endoscopic swallowing test. All patients had swallowing disorders at admission. The first functional swallowing test showed oral (77.8 %) and pharyngeal (66.7 %) food bolus transport disorders; and alterations in airway protection mechanisms (80 %). Swallowing test under endoscopic control showed a disorder in swallowing coordination in 55.6 % of patients tested. Seven (63.6 %) patients resumed oral feeding within an average of 6 weeks after admission to rehabilitation center and 14 weeks after acquired brain injury. Six (85.7 %) of these seven patients continued to require modified solid and liquid textures. Swallowing disorders are a major concern in severe brain injury in the arousal phase. Early bedside assessment of swallowing is essential for detection of swallowing disorders to propose appropriate medical rehabilitation care to these patients in a state of altered consciousness.
authors.affiliation: Physical Medicine and Rehabilitation Center "les Herbiers", 111 rue Herbeuse, 79230, Bois Guillaume, France.
authors.forename: A
authors.initials: A
authors.lastname: Bremare
authors.affiliation: Physical Medicine and Rehabilitation Center "les Herbiers", 111 rue Herbeuse, 79230, Bois Guillaume, France.
authors.forename: A
authors.initials: A
authors.lastname: Rapin
authors.affiliation: Intensive Care Department, Rouen University Hospital, Rouen, France.
authors.forename: B
authors.initials: B
authors.lastname: Veber
authors.affiliation: Rouen University Hospital, Rouen, France.
authors.forename: F
authors.initials: F
authors.lastname: Beuret-Blanquart
authors.affiliation: Physical Medicine and Rehabilitation Center "les Herbiers", 111 rue Herbeuse, 79230, Bois Guillaume, France. eric.verin@chu-rouen.fr.|Physiology Department, Rouen University Hospital, Rouen, France. eric.verin@chu-rouen.fr.|EA 3830 Research Group on Ventilatory Handicap, IRIB, Normandy University, Rouen, France. eric.verin@chu-rouen.fr.
authors.forename: E
authors.initials: E
authors.lastname: Verin
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology*; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000503:physiopathology; D010808:Physical Examination / Q000379:methods*; D000067716:Point-of-Care Testing; D012047:Rehabilitation Centers
keywords: Deglutition; Deglutition disorders; Disorders of consciousness; Severe acquired brain injury; Swallowing disorders