CoDAS
https://codas.org.br/article/doi/10.1590/2317-1782/20212021023
CoDAS
Case Report

Oropharyngeal dysphagia telerehabilitation in the Intensive Care Unit for COVID-19: a case report

Shigeto Soyama; Tomoo Mano; Akira Kido

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Abstract

The face-to-face assessment of and training for dysphagia are considered aerosol-generating procedures, and thus are contraindicated for patients who are positive or suspected of having severe acute respiratory syndrome coronavirus 2 infection. Considering the extremely infectious nature of the virus, transmission to other individuals during rehabilitation is possible. Some patients in the intensive care unit and those who are on endotracheal intubation and mechanical ventilation often have dysphagia. Therefore, assessment and training for oropharyngeal dysphagia are provided by rehabilitation professionals to restore normal feeding before patient discharged. Thus, we aimed to explore the advantages of telerehabilitation in dysphagia management during the coronavirus disease 2019 (COVID-19) pandemic. An infected 50-year-old man admitted to the hospital underwent extracorporeal membrane oxygenation rescue therapy and tracheostomy. Upon gradual respiratory status stabilization, extracorporeal membrane oxygenation therapy was discontinued, and he was weaned off the ventilator. He had difficulty swallowing and coughed after attempting to drink fluids. We considered the application of telerehabilitation for managing dysphagia while minimizing the risk of infection and usage of personal protective equipment. A videoconferencing software on a tablet device provided contactless telerehabilitation, thus reducing the risk of infection and preventing personal protective equipment shortage. Moreover, it facilitates discussion on the issues related to the evaluation of oropharyngeal dysphagia telerehabilitation. We highlight important considerations for the application of telerehabilitation in the assessment and treatment of dysphagia during the COVID-19 pandemic.

Keywords

Coronavirus Infections; COVID-19; Oropharyngeal Dysphagia; Swallowing Disorders; Rehabilitation; Telerehabilitation; Ventilation

Referências

1. Wujtewicz M, Dylczyk-Sommer A, Aszkiełowicz A, Zdanowski S, Piwowarczyk S, Owczuk R. COVID-19 - what should anethesiologists and intensivists know about it? Anaesthesiol Intensive Ther. 2020;52(1):34-41. http://dx.doi.org/10.5114/ait.2020.93756. PMid:32191830.

2. Brugliera L, Spina A, Castellazzi P, Cimino P, Tettamanti A, Houdayer E, et al. Rehabilitation of COVID-19 patients. J Rehabil Med. 2020;52(4):jrm00046. http://dx.doi.org/10.2340/16501977-2678.

3. Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV and controls on dental practice. Int J Oral Sci. 2020;12(1):9. http://dx.doi.org/10.1038/s41368-020-0075-9. PMid:32127517.

4. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. http:// dx.doi.org/10.1016/S0140-6736(20)30566-3.

5. Mattei A, Amy de la Bretèque B, Crestani S, Crevier-Buchman L, Galant C, Hans S, et al. Guidelines of clinical practice for the management of swallowing disorders and recent dysphonia in the context of the COVID-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis. 2020;137(3):173-5. http://dx.doi.org/10.1016/j.anorl.2020.04.011. PMid:32332004.

6. Burns CL, Ward EC, Hill AJ, Kularatna S, Byrnes J, Kenny LM. Randomized controlled trial of a multisite speech pathology telepractice service providing swallowing and communication intervention to patients with head and neck cancer: an evaluation of service outcomes. Head Neck. 2017;39(5):932-9. http://dx.doi.org/10.1002/hed.24706. PMid:28225567.

7. Burns CL, Ward EC, Gray A, Baker L, Cowie B, Winter N, et al. Implementation of speech pathology telepractice services for clinical swallowing assessment: an evaluation of service outcomes, costs, and consumer satisfaction. J Telemed Telecare. 2019;25(9):545-51. http:// dx.doi.org/10.1177/1357633X19873248. PMid:31631757.

8. Ward EC, Sharma S, Burns C, Theodoros D, Russell T. Validity of conducting clinical dysphagia assessments with patients with normal to mild cognitive impairments via Telerehabilitation. Dysphagia. 2012;27(4):460-72. http:// dx.doi.org/10.1007/s00455-011-9390-9. PMid:22271284.

9. Dimer NA, Canto-Soares ND, Santos-Teixeira LD, Goulart BNG. The COVID-19 pandemic and the implementation of telehealth in speech-language and hearing therapy for patients at home: an experience report. CoDAS. 2020;32(3):e20200144. http://dx.doi.org/10.1590/2317-1782/20192020144. PMid:32578694.

10. Ward EC, Burns CL. Dysphagia management via telerehabilitation: a review of the current evidence. J Gastroenterol Hepatol Res [Internet]. 2014 [cited 2021 June 2];3(5):1088-94. Available from: http://www.ghrnet. org/index.php/joghr/article/view/699

11. Winters JM. Telerehabilitation research: emerging opportunities. Annu Rev Biomed Eng. 2002;4(1):287-320. http://dx.doi.org/10.1146/annurev. bioeng.4.112801.121923. PMid:12117760.

12. Kushalnagar P, Paludneviciene R, Kushalnagar R. Video remote interpreting technology in health care: cross-sectional study of deaf patients’ experiences. JMIR Rehabil Assist Technol. 2019;6(1):e13233. http://dx.doi. org/10.2196/13233.

13. Freitas A, Zica G, Albuquerque C. Coronavirus pandemic (COVID-19): what speech therapists should know. CoDAS. 2020;32(3):e20200073. http://dx.doi.org/10.1590/2317-1782/20192020073.

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