Effects of oral intake of water in patients with oropharyngeal dysphagia
水分制限や水飲みテストに代表されるように嚥下障害における水分は生活上でも、スクリーニング上でも重要である。
BMC Geriatrics（IF2.34) に「嚥下障害者における水分摂取の影響」 （Martha JP Karagiannis, Leonie Chivers,and Tom C Karagiannis,2011, 11:9）が掲載されている。
Abstract Background: Dysphagia is associated with numerous medical conditions and the major intervention to avoid aspiration in people with dysphagia involves modifying the diet to thickened fluids. This is associated with issues related to patient quality of life and in many cases non-compliance leading to dehydration. Given these concerns and in the absence of conclusive scientific evidence, we designed a study, to further investigate the effects of oral intake of water in people with dysphagia. Methods. We monitored lung related complications, hydration levels and assessed quality of life in two groups of people with dysphagia. The control group was allowed only thickened fluids and patients in the intervention group were allowed access to water for a period of five days. Results: Our findings indicate a significantly increased risk in the development lung complications in patients given access to water (6/42; 14.3%) compared to the control group (0/34; no cases). We have further defined patients at highest risk, namely those with degenerative neurologic dysfunction who are immobile or have low mobility. Our results indicate increased total fluid intake in the patients allowed access to water, and the quality of life surveys, albeit from a limited number of patients (24% of patients), suggest the dissatisfaction of patients to diets composed of only thickened fluids. Conclusions: On the basis of these findings we recommend that acute patients, patients with severe neurological dysfunction and immobility should be strongly encouraged to adhere to a thickened fluid or modified solid consistency diet. We recommend that subacute patients with relatively good mobility should have choice after being well-informed of the relative risk．
急性期患者は誤嚥があると水分制限されることが多いが、QOL上ストレスを感じていることがある。そのため、直接水分投与では誤嚥性肺炎を引き起こしてしまうリスクがある。しかし、水分に形態調整することで、水分投与が可能になり、QOLの向上につながる。
基本的なことかもしれないが、水分制限はストレスにつながることを意識し介入することが大切と考えさせられた。
BMC Geriatrics（IF2.34) に「嚥下障害者における水分摂取の影響」 （Martha JP Karagiannis, Leonie Chivers,and Tom C Karagiannis,2011, 11:9）が掲載されている。
Abstract Background: Dysphagia is associated with numerous medical conditions and the major intervention to avoid aspiration in people with dysphagia involves modifying the diet to thickened fluids. This is associated with issues related to patient quality of life and in many cases non-compliance leading to dehydration. Given these concerns and in the absence of conclusive scientific evidence, we designed a study, to further investigate the effects of oral intake of water in people with dysphagia. Methods. We monitored lung related complications, hydration levels and assessed quality of life in two groups of people with dysphagia. The control group was allowed only thickened fluids and patients in the intervention group were allowed access to water for a period of five days. Results: Our findings indicate a significantly increased risk in the development lung complications in patients given access to water (6/42; 14.3%) compared to the control group (0/34; no cases). We have further defined patients at highest risk, namely those with degenerative neurologic dysfunction who are immobile or have low mobility. Our results indicate increased total fluid intake in the patients allowed access to water, and the quality of life surveys, albeit from a limited number of patients (24% of patients), suggest the dissatisfaction of patients to diets composed of only thickened fluids. Conclusions: On the basis of these findings we recommend that acute patients, patients with severe neurological dysfunction and immobility should be strongly encouraged to adhere to a thickened fluid or modified solid consistency diet. We recommend that subacute patients with relatively good mobility should have choice after being well-informed of the relative risk．
急性期患者は誤嚥があると水分制限されることが多いが、QOL上ストレスを感じていることがある。そのため、直接水分投与では誤嚥性肺炎を引き起こしてしまうリスクがある。しかし、水分に形態調整することで、水分投与が可能になり、QOLの向上につながる。
基本的なことかもしれないが、水分制限はストレスにつながることを意識し介入することが大切と考えさせられた。
Fig:Outline of participant groupings and study methodology.
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