DYSPHAGIA-EBM (ORAL VS. PARENTERAL NUTRITION)

SUMMARY

1. Enteral feeding with modifications of bolus size & consistency if patient is able to tolerate orally without aspiration.

2. Bolus consistencies: thin fluids, honey/thickened fluids, pureed/soft foods, minced diet, normal/full diet.

3. Parenteral feeding if clear contraindication to enteral feeding.

4. Contraindications: pulmonary pathology due to aspiration with documented airway contamination, decreased consciousness, decreased pharyngeal & laryngeal movements on VFSS/MBS.

5. PEG indications: patients who are unable to tolerate grade 3 thickened fluids or pureed diet after 14 days post-stroke, contraindications to oral feeding.

6. PEG should be carried out early before respiratory failure or severe dysphagia occurs.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.