tailieunhanh - Acute Ischemic Stroke Part 6

Tham khảo tài liệu 'acute ischemic stroke part 6', khoa học tự nhiên, công nghệ sinh học phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | 4 Dysphagia and Respiratory Infections in Acute Ischemic Stroke Claire Langdon Sir Charles Gairdner Hospital Curtin University of Technology Australia 1. Introduction Eating and swallowing are activities that are normally performed without conscious thought. This complex behaviour - involving 5 pairs of cranial nerves and 26 pairs of muscles - can be interrupted by a stroke leading to dysphagia. Dysphagia is associated with aspiration where material passes into the respiratory tract and aspiration carries a risk of pneumonia seven times greater than that of the normal population. Around 15 - 20 of all stroke patients will develop respiratory tract infections during the acute phase of their stroke. Pneumonia is one of the leading causes of mortality in the acute stroke patient. Respiratory infections add to hospital length of stay and are associated with significant increases in the cost of patient care as well as being associated with poorer outcomes for the patient. This chapter will outline the association of dysphagia and other risk factors in the development of respiratory infections in acute ischemic stroke patients. 2. High early incidence of dysphagia its causes presentation and implications Swallowing is a vital motor activity that serves alimentary purposes and protects the upper airway Jean 2001 . Dysphagia difficulty eating and swallowing is very common after an ischemic stroke affecting between 13 and 94 of all ischemic stroke patients with the incidence depending on the size and location of the lesion Barer 1989 DePippo Holas Reding Mandel Lesser 1994 Daniels 2000 Ding Logemann 2000 Aydogdu Ertekin Tarlaci Turman Klyliogly 2001 Marik 2001 . Dysphagia can lead to malnutrition dehydration aspiration pneumonia and increased length of hospital stay. In a recent review of the costs to the US health system dysphagia was found to be associated with significantly increased costs due to increased length of stay and infections. The median hospitalization days .