Introduction:

Swallowing disorders are an important factor of morbidity and mortality, endoscopic fibroscopic evaluation has tangible advantages against other types of deglutition studies. The critically ill patient with dysphagia has been studied in relation to different risk factors such as medications, invasive procedures and different pathologies, however, in few studies a direct relationship is sought with respect to the causative mechanism of the swallowing disorder.

Objectives:

To establish the relationship between different risk factors with dysphagia in the oral phase, the pharyngeal phase and with the presence of laryngeal penetration or tracheal aspiration in patients who have undergone critical care and assess the risk factors according to the anatomical substrate in which it develops on.

Material and methods:

We conducted a study of an observational, retrospective cohort, which exclusively included patients admitted to intensive and intermediate therapy from July 2016 to February 2019, of over 18 years of age, who were studied with endoscopic fibroscopy for dysphagia. A univariate analysis of selected factors was performed, the statistical analysis was prepared in SPSS v.21, frequency measurements were analyzed and the risk factor analysis was performed with Fisher test and χ2 test.

Results:

A total of 40 evaluations were performed by endoscopic fibroscopy, a deglutition disorder was confirmed in 82% of the patients, 18 males and 15 females. 30% had laryngeal penetration, 18% had tracheal aspiration, 60% had alteration of the oral phase and 66% had alterations in the pharyngeal phase. Laryngeal penetration was associated with the use of nasogastric tubes (p 0.02), tracheal aspiration with the use of opioids (p 0.05) and benzodiazepines (p 0.05). In the case of alterations of the oral phase, the use of opioids was associated (p 0.03) and in alterations of the pharyngeal phase there was no associated risk factor.

Conclusion:

The development of deglutition disorders in critical patients is not related to a single cause, multiple risk factors have been associated in different studies but the synergy between different events and/or predisposing factors has not been associated. We must consider that different risk factors may have a similar anatomophysiological substrate, causing multiple events to result in a significant swallowing disorder.

        · abstract in Spanish | Portuguese     · text in Spanish     · Spanish ( pdf )