Swallowing and swallowing-breathing interaction as predictors of intubation in Guillain-Barré syndrome.

Détails

ID Serval
serval:BIB_1C10603EFB50
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Swallowing and swallowing-breathing interaction as predictors of intubation in Guillain-Barré syndrome.
Périodique
Brain and behavior
Auteur(s)
Ogna A., Prigent H., Lejaille M., Samb P., Sharshar T., Annane D., Lofaso F., Orlikowski D.
ISSN
2162-3279 (Electronic)
Statut éditorial
Publié
Date de publication
02/2017
Peer-reviewed
Oui
Volume
7
Numéro
2
Pages
e00611
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Bulbar weakness and respiratory impairment have been associated with increased morbidity in retrospective studies of Guillain-Barré syndrome (GBS) patients. The aim of this study was to prospectively explore the relationship between subclinical swallowing impairment, respiratory function parameters, the necessity to intubate patients and the development of early postintubation pneumonia in patients with GBS in the intensive care unit (ICU).
Respiratory, swallowing, and tongue strength parameters were measured in 30 consecutive adults (51.7 ± 18.1 years old), hospitalized for GBS in the ICU of a teaching hospital. Twenty healthy volunteers were recruited as a control group. The primary outcomes were intubation and pneumonia during the ICU stay.
Nineteen patients (65.5%) had piecemeal swallowing, and 19 (65.5%) had impaired breathing-swallowing interaction, of which, respectively, 47.4% and 52.6% had a clinically apparent swallowing impairment. Swallowing impairment was associated with lower values of respiratory function, but not with peripheral motor weakness. Tongue protrusion strength was correlated with respiratory parameters and swallowing impairment. Ten patients were intubated and six developed pneumonia. Age, BMI, severe axial involvement, respiratory parameters (vital capacity and respiratory muscle strength), tongue protrusion strength, and clinical swallowing impairment were predictors of intubation.
Swallowing impairment was present early after ICU admission in over 80% of patients and was an important predictor of intubation. A systematic clinical evaluation of swallowing should be carried out, eventually combined with an evaluation of tongue protrusion strength, along with the usual assessment of neurological and respiratory function, to determine the severity of the GBS.

Mots-clé
Guillain‐Barré syndrome, ICU, dysphagia, intubation, tongue strength, vital capacity
Pubmed
Web of science
Création de la notice
25/08/2017 11:18
Dernière modification de la notice
03/03/2018 14:31
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