Abstract
OBJETIVO:associar o grau de disfagia orofaríngea e o tempo de intubação orotraqueal no indivíduo pós-acidente vascular encefálico após cirurgia cardíaca.MÉTODOS:estudo clínico transversal descritivo, retrospectivo, realizado por meio da coleta de dados de protocolos e registros de prontuário, durante seis meses, em Hospital Público de Referência em Cardiologia. Foram analisados 25 protocolos e prontuários de indivíduos submetidos à cirurgia cardíaca, que evoluíram com acidente vascular encefálico e foram assistidos pela equipe de Fonoaudiologia. Os indivíduos foram divididos em dois grupos. O Grupo I (GI) constou de 10 indivíduos com intubação orotraqueal menor que 24 horas e o Grupo II (GII) de 15 indivíduos com intubação orotraqueal maior que 24 horas. Realizada avaliação clínica da deglutição e analisada a associação entre a classificação clínica do grau de comprometimento para disfagia e o tempo de intubação orotraqueal.RESULTADOS:verificou-se que no GI 40% apresentaram disfagia leve, 30% moderada e 20% grave. No GII 13,3% apresentaram disfagia leve, 33,3% moderada e 53,33% grave. Verificou-se associação linear significante entre o grau de disfagia e o tempo de IOT (p= 0,031), indicando que o número de indivíduos com disfagia moderada e grave foi maior no grupo com mais tempo de intubaçao.CONCLUSÕES:constatou-se que o tempo de intubação orotraqueal maior que 24 horas aumentou o grau da disfagia orofaríngea nesta população.
Highlights
Cardiovascular disease (CVD) is considered to be the most frequent cause of death worldwide and according to the projections for 2020, will remain as the main cause 1
The medical records of all individuals who have undergone cardiac surgery and evolved with postoperative stroke, within six months, between 2010 and 2011, and were assisted by a speech-language pathology team specialized in dysphagia after medical request were analyzed .We analyzed the medical records of all the individuals who have undergone cardiac surgery and evolved with postoperative stroke, within six months, between 2010 and 2011, and were assisted by a speech-language pathology team specialized in dysphagia after medical request
For the classification of moderate dysphagia we considered labial alteration, lack of tongue coordination, pharyngeal response delay, absence of cough or cough presence before, during or after swallowing
Summary
Cardiovascular disease (CVD) is considered to be the most frequent cause of death worldwide and according to the projections for 2020, will remain as the main cause 1. The improvement of operative techniques allowed the reduction in the rate of mortality and morbidity, neurological complications in intra and postoperative remain being a common problem 2,3. The most common neurological deficit is stroke 4 and represents the second most frequent cause of perioperative mortality[5]. The causes of stroke in the peri and postoperative periods are multiple. Among these are the use of extra corporeal circulation (ECC) 2,4, atrial fibrillation (AF) 6,7, presence of atherosclerosis in the aorta and carotid arteries 2, old age , 2,4,6 global or local hypoperfusion or haematological alterations, microembolization in intraoperative 2, prolonged clamping time 5. The risk of developing stroke increases the associated risk factors such as obesity, smoking, dyslipidemia, hypertension and diabetes mellitus 1,8
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