Dysphagic patients on thickened-fluid diets at risk of dehydration

מתוך medicontext.co.il
NEW YORK (Reuters Health) – Stroke patients with dysphagia who receive thickened fluid diets often fail to meet daily fluid requirements, Canadian researchers report in the December issue of the Archives of Physical Medicine and Rehabilitation.

Dr. Hillel Finestone of the University of Ottawa in Ontario and colleagues followed 13 dysphagic stroke patients for 3 weeks after admission to the hospital. Seven patients were started on nonoral, enteral feedings plus intravenous fluids, progressing eventually to oral feedings. Six patients received oral, thickened-fluid diets from the outset.

Dr. Finestone reports that fluid intake in the 7 patients started on enteral nutrition and IV fluids "significantly declined over the 21 days." Fluid intake dropped from 3158 mL, or 134% of the daily fluid requirement, on day one to 984 mL, or 43% of the daily requirement, by day 21.

Mean fluid intake of patients who received only oral feedings was 755 mL/day, or 33% of the daily fluid requirement.

The investigators recommend that "sufficient quantities of fluids should be offered along with protocols that monitor and support hydration. If this is unrealistic, then complementary hydration strategies, such as intravenous therapy or maintaining enteral tubes to provide additional fluid, should become normal standards of practice for patients with these dietary restrictions [dysphagia]."

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