Stepping Stones to Living Well with Dysphagia , livre ebook

S. Karger AG

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114 pages

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Oropharyngeal dysphagia is a major complaint among many patients suffering from neurological diseases as well as in the elderly. Its severity ranges from moderate difficulty to complete inability to swallow, and it may give rise to clinically relevant complications such as aspiration pneumonia, malnutrition and/or dehydration, impaired quality of life, and death. However, despite its high prevalence and even though it would be very cost-effective to avoid complications by adequate treatment, dysphagia is still severely underdiagnosed. The contributions in this book present and discuss state-of-the-art diagnostic methods, treatment, and care of dysphagia patients, putting special emphasis on a multidisciplinary approach. A variety of clinical specialists will find this publication a most valuable addition to their library, including nurses, speech-language pathologists, dieticians, nutritionists, gastroenterologists and related specialties.

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Publié par	S. Karger AG
Date de parution	24 septembre 2012
Nombre de lectures	0
EAN13	9783318021141
Langue	English
Poids de l'ouvrage	1 Mo

Informations légales : prix de location à la page 0,0148€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.

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Nestlé Nutrition Institute Workshop Series
Vol. 72

Stepping Stones to Living Well with Dysphagia
Editors
Julie Cichero Brisbane, Australia
Pere Clavé Barcelona, Spain
Nestec Ltd., 55 Avenue Nestlé, CH–1800 Vevey (Switzerland)
S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland) www.karger.com
Library of Congress Cataloging-in-Publication Data
Nestlé Nutrition Workshop (72nd : 2012 : Barcelona, Spain)
Stepping stones to living well with dysphagia / editors, Julie Cichero, Pere Clavé.
p. ; cm. -- (Nestlé Nutrition Institute workshop series, ISSN 1664-2147 ; v. 72)
Includes bibliographical references and index.
ISBN 978-3-318-02113-4 (hard cover: alk. paper) -- ISBN 978-3-318-02114-1 (e-ISBN)
I. Cichero, Julie A. Y. II. Clavé, Pere. III. Nestlé Nutrition Institute. IV. Title. V. Series: Nestlé Nutrition Institute workshop series ; v. 72. 1664-2147
[DNLM: 1. Deglutition Disorders--Congresses. W1 NE228D v.72 2012 / WI 250]
616.3’23--dc23
2012029498
The material contained in this volume was submitted as previously unpublished material, except in the instances in which credit has been given to the source from which some of the illustrative material was derived.
Great care has been taken to maintain the accuracy of the information contained in the volume. However, neither Nestec Ltd. nor S. Karger AG can be held responsible for errors or for any consequences arising from the use of the information contained herein.
© 2012 Nestec Ltd., Vevey (Switzerland) and S. Karger AG, Basel (Switzerland). All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, or recording, or otherwise, without the written permission of the publisher.
Printed on acid-free and non-aging paper
ISBN 978–3–318–02113–4
e-ISBN 978–3–318–02114–1
ISSN 1664–2147
e-ISSN 1664–2155

Contents
Preface
Foreword
Contributors
Introduction
Definition, Prevalence and Burden of Oropharyngeal Dysphagia: A Serious Problem among Older Adults Worldwide and the Impact on Prognosis and Hospital Resources
Cichero, J.A.Y. (Australia); Altman, K.W. (USA)
The Physiology of Deglutition and the Pathophysiology and Complications of Oropharyngeal Dysphagia
Steele, C.M. (Canada)
Detection
Identifying Vulnerable Patients: Role of the EAT-10 and the Multidisciplinary Team for Early Intervention and Comprehensive Dysphagia Care
Kaspar, K. (Switzerland); Ekberg, O. (Sweden)
The Volume-Viscosity Swallow Test for Clinical Screening of Dysphagia and Aspiration
Rofes, L.; Arreola, V.; Clavé, P. (Spain)
Videofluoroscopic Swallow Study: Techniques, Signs and Reports
Bülow, M. (Sweden)
Screening and Clinical Assessment of Oropharyngeal Dysphagia
Martino, R. (Canada)
Dysfunction and Related Complications
Pathophysiology, Relevance and Natural History of Oropharyngeal Dysphagia among Older People
Clavé, P.; Rofes, L.; Carrión, S.; Ortega, O.; Cabré, M.; Serra-Prat, M.; Arreola, V. (Spain)
Complications of Oropharyngeal Dysphagia: Aspiration Pneumonia
Almirall, J.; Cabré, M.; Clavé, P. (Spain)
Nutrition Assessment and Intervention in the Patient with Dysphagia: Challenges for Quality Improvement
Ochoa, J.B. (USA)
Interventions
Therapeutic Approach to Malnutrition and Sarcopenia
Burgos Peláez, R. (Spain)
Importance of Nutritional Support in Older People
Sánchez García, E.; Montero Errasquín, B.; Sánchez Castellano, C.; Cruz-Jentoft, A.J. (Spain)
Exercise-Based Approaches to Dysphagia Rehabilitation
Steele, C.M. (Canada)
Oropharyngeal Dysphagia Pathophysiology, Complications and Science-Based Interventions
Altman, K.W. (USA)
Concluding Remarks
Subject Index
For more information on related publications, please consult the NNI website: www.nestlenutrition-institute.org

Preface
Oropharyngeal dysphagia is a major complaint among many patients with neurological diseases and in the elderly. Oropharyngeal dysphagia is specifically classified by the World Health Organization in the International Statistical Classification of Diseases and Related Health Problems ICD-9 and ICD-10 (787.2, R13). The severity of oropharyngeal dysphagia varies from moderate difficulty to complete inability to swallow, and may give rise to clinically relevant complications such as aspiration pneumonia, malnutrition and/or dehydration, impaired quality of life and death. There is a big discrepancy between the high prevalence, morbidity, mortality and costs caused by nutritional and respiratory complications of oropharyngeal dysphagia and the low level of resources dedicated to dysphagic patients.
The main aim of the Second International Course on Oropharyngeal Dysphagia, the 72nd Nestlé Nutrition Institute Workshop ‘Stepping Stones to Living Well with Dysphagia’ held at the Hospital de Mataró, Spain, May 5–6, 2011, was to educate on science-based state-of-the-art practices in dysphagia patient care to improve the clinical management of our patients with oropharyngeal dysphagia. Our aim was to give the attendants five messages about oropharyngeal dysphagia to take home: (a) oropharyngeal dysphagia is a very frequent and serious symptom with specific nutritional and respiratory complications that can lead to death; (b) dysphagia can be diagnosed, and we provided them clinical methods for screening and complementary explorations for accurate diagnosis; (c) dysphagia can be treated, and treatment is cost-effective because complications are avoided; (d) diagnosis and treatment of dysphagia require a multidisciplinary approach involving several professional domains and interdisciplinary dysphagia care, and (e) research into new strategies is required to understand the pathophysiology and new treatments for impaired swallow response.
Over the two days of the course, we heard top dysphagia specialists from around the world present and discuss the state-of-the-art of science-based methods of diagnosis, treatment and dysphagia patient care. In addition, several practical sessions with real patients, discussion of clinical cases and practices with products provided the participants with real examples of application of all this knowledge in a real clinical setting. The program of the course was also designed to promote networking, communication and interaction within attendants and speakers. This publication promoted by the Nestlé Nutrition Institute includes some of the most relevant presentations of the course, and the conclusions provide a short summary and conclusions of the discussions and deliberations during the meeting.
We believe that identification of oropharyngeal dysphagia as a major neurological and geriatric syndrome will cause many changes in the provision of medical and social services in the near future. Education of health care professionals in diagnosis and treatment of dysphagia and its complications, early diagnosis, development of specific complementary explorations in the clinical setting, improvement in therapeutic strategies to avoid aspirations and malnutrition, and research into its pathophysiology are the cornerstones to allow maximal recovery potential for patients with functional oropharyngeal dysphagia. This book represents an excellent starting point for this process.
Julie Cichero
Pere Clavé

Foreword
Epidemiologic studies suggest that 22% of individuals over 50 years suffer from dysphagia, while the prevalence rises to nearly 40% in those over 60 years. Despite its high prevalence, dysphagia is severely underdiagnosed (in 60% of cases) and permitted to go unmanaged (in 66% of cases), even in clinical settings providing specialized care of older adults. Sadly, poorly managed dysphagia is known to diminish patient quality of life and heighten morbidity, mortality, and costs.
Due to the multifactorial etiology and clinical complications associated with dysphagia, the comprehensive needs of patients are best treated by a multidisciplinary health care team. In an effort to spread the use of science-based, state-of-the-art practices in dysphagia, the Nestlé Nutrition Institute organized the 2nd International Course on Oropharyngeal Dysphagia themed ‘Stepping Stones to Living Well with Dysphagia’, which was also the 72nd in the series of Nestlé Nutrition Institute Workshops. The 2-day theoretical and practical educational event took place at Mataró Hospital in Spain. The program enabled leading clinicians including nurses, speech-language pathologists, dietitians, nutritionists, gastroenterologists, and additional specialties to connect and share best practices with other dysphagia specialists from across the world.
A major success of the course was to bring together a diverse group, from specialists involved in medical practice to those immersed in research including engineers and other scientists. The program stimulated thinking beyond the current approach and inspired consideration of different science-based practices. Participants learned about novel, validated methods that could be applied in daily practice, as well as emerging therapies for dysphagia. All gained skill at a comprehensive set of evidence-based clinical methods for screening, assessing, diagnosing, and identifying the best tr