Traqueostomía y deglución en tiempos de pandemia. Revisión narrativa

Contenido principal del artículo

Guillermo Chiappero
Alejandra Faldutti
María Eugenia Catini

Resumen

La evaluación de la deglución en pacientes con traqueostomía representa un desafío en el contexto de la pandemia de COVID-19. El objetivo de esta revisión fue analizar las publicaciones disponibles sobre la evaluación y el diagnóstico de disfagia en el paciente con traqueostomía y los cuidados de los profesionales de la salud frente a los procedimientos generadores de aerosoles.


Se completó una búsqueda bibliográfica utilizando las siguientes palabras clave en inglés y español, según correspondiera: “tracheostomy”, “dysphagia”, “coronavirus”, “COVID-19”, “SARS-CoV-2”, “swallowing”, “deglutition”, en las bases de datos electrónicas PubMed, SciELO, EMBASE y Google Scholar. Además, se revisaron las guías de recomendaciones publicadas por las sociedades científicas pertinentes.


La evaluación y el diagnóstico de las alteraciones deglutorias implican el contacto directo con la vía aérea superior del paciente e involucran procedimientos que pueden generar aerosoles. Por lo tanto, deberán realizarse en forma oportuna, en consenso con todo el equipo tratante y utilizando siempre un equipo de protección personal adecuado para disminuir el riesgo de contaminación y transmisión del virus al personal de la salud.

Detalles del artículo

Cómo citar
1.
Chiappero G, Faldutti A, Catini ME. Traqueostomía y deglución en tiempos de pandemia. Revisión narrativa. Rev Arg de Ter Int. [Internet]. 24 de agosto de 2021 [citado 19 de noviembre de 2024];38. Disponible en: https://revista.sati.org.ar/index.php/MI/article/view/789
Sección
Revisiones

Citas

1. Ríos F, Risso Vazquez A, Diaz Ballve L. Enfermedad por coronavirus 2019 COVID-19 aspectos de interés para cuidados críticos: Revisión narrativa. RATI 2020; (Supl. 1): 1-12.
2. Kassirian S, Taneja R, Mehta S. Diagnosis and management of acute respiratory distress syndrome in a time of COVID-19. Diagnostics (Basel) 2020 ;10(12): 1053. https://doi.org/10.3390/diagnostics10121053
3. Skoretz SA, Anger N, Wellman L, Takai O, Empey A. A systematic review of tracheostomy modifications and swallowing in adults. Dysphagia 2020; 35: 935-947. https://doi.org/10.1007/s00455-020-10115-0
4. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-1720. https://doi.org/10.1056/NEJMoa2002032
5. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323: 1061-1069. https://doi.org/10.1001/jama.2020.1585
6. Zou L, Ruan F, Huang M, et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med 2020; 382(12): 1177-1779. https://doi.org/10.1056/NEJMc2001737
7. Chen C, Gao G, Xu Y, et al. SARS-CoV-2-positive sputum and feces after conversion of pharyngeal samples in patients with COVID-19. Ann Intern Med 2020; 172(12): 832-834. https://doi.org/10.7326/ M20-0991
8. Zhao J, Yuan Q, Wang H, et al. Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019. Clin Infect Dis 2020; 71(16): 2027-2034. https://doi.org/10.1093/cid/ciaa344
9. McGrath BA, Ashby N, Birchall M, et al. Multidisciplinary guidance for safe tracheostomy care during the COVID-19 pandemic: the NHS National Patient Safety Improvement Programme (NatPatSIP). Anaesthesia 2020; 75(12): 1659-1670. https://doi.org/10.1111/anae.15120
10. Chan JYK, Wong EWY, Lam W. Practical aspects of otolaryngologic clinical services during the 2019 novel coronavirus epidemic: an experience in Hong Kong. JAMA Otolaryngol Neck Surg 2020; 146(6): 519-520. https://doi.org/10.1001/ jamaoto.2020.0488
11. Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One 2012; 7(4): e35797. https://doi.org/10.1371/journal.pone.0035797
12. Rovira A, Dawson D, Walker A, et al. Tracheostomy care and decannulation during the COVID-19 pandemic. A multidisciplinary clinical practice guideline. Eur Arch Otorhinolaryngol 2020; 278(2): 313-321. https://doi.org/10.1007/s00405-020-06126-0
13. Bolton L, Mills C, Wallace S, Brady MC. Aerosol generating procedures, dysphagia assessment and COVID-19. A rapid review. Royal College of Speech and Language Therapists (RCSLT) COVID-19 Advisory group. Int J Lang Commun Disord 2020; 55(4): 629-636. https://doi.org/10.1111/1460-6984.12544
14. Centers for Disease Control and Prevention (CDC) Interim infection prevention and control recommendations for patients with suspected or confirmed coronavirus disease 2019 (COVID-19) in healthcare settings, 2020. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html
15. Cook TM. Personal protective equipment during the COVID-19 pandemic – a narrative review. Anaesthesia 2020; 75(7): 920-927. https://doi.org/10.1111/anae.15071
16. Evans MJ. Avoiding COVID-19: aerosol guidelines. BMJ Yale 2020. https://doi.org/10.1101/2020.05.21.20108894
17. Miles A, Connor NP, Desai RV, et al. Dysphagia care across the continuum: A Multidisciplinary Dysphagia Research Society Taskforce Report of Service Delivery During the COVID 19 Global Pandemic. Dysphagia 2020; 36(2): 170-182. https://doi.org/13.10.1007/s00455-020-10153-8
18. Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and metaanalysis. Lancet 2020; 395(10242): 1973-1987. https://doi.org/10.1016/S0140-6736(20)31142-9
19. World Health Organization. Modes of transmission of virus causing COVID-19: Implications for IPC precaution recommendations. Scientific Brief 2020; 29 March. Disponible en: https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations
20. Vergara J, Skoretz SA, Brodsky MB, et al. Assessment, diagnosis, and treatment of dysphagia in patients infected with SARS-CoV-2: A review of the literature and international guidelines. Am J Speech Lang Pathol 2020; 29(4): 2242-2253. https://doi.org/10.1044/2020_AJSLP-20-00163
21. Freeman-Sanderson A, Ward EC, Miles A, et al; COVID-19 SLP Global Group. A consensus statement for the management and rehabilitation of communication and swallowing function in the ICU: A global response to COVID-19. Arch Phys Med Rehabil 2020; S0003-9993(20)31210-7. https://doi.org/10.1016/j.apmr.2020.10.113
22. Dziewas R, Warnecke T, Zürcher P, Schefold JC. Dysphagia in COVID-19 –multilevel damage to the swallowing network? Eur J Neurol 2020; 27(9): e46-e47. https://doi.org/10.1111/ene.14367
23. Brodsky MB, Levy MJ, Jedlanek E, et al. Laryngeal injury and upper airway symptoms after oral endotracheal intubation with mechanical ventilation during critical care: a systematic review. Crit Care Med 2018; 46(12): 2010‐2017. https://doi.org/10.1097/CCM.0000000000003368
24. Medeiros GC, Sassi FC, Lirani-Silva C, Andrade CRF. Criteria for tracheostomy decannulation: literature review. Codas 2019; 31(6): e20180228. https://doi.org/10.1590/2317-1782/20192018228
25. Thille AW, Boissier F, Muller M, et al. Role of ICU-acquired weakness on extubation outcome among patients at high risk of reintubation. Crit Care 2020; 24: 86. https://doi.org/10.1186/s13054-020-2807-9
26. Mohan R, Mohapatra B. Shedding light on dysphagia associated with COVID-19: The what and why. OTO Open 2020; 4(2): 1-2. https://doi.org/10.1177/2473974X20934770
27. Frajkova Z, Tedla M, Tedlova E, Suchankova M, Geneid A. Postintubation dysphagia during COVID 19 outbreak Contemporary review. Dysphagia 2020; 35(4): 549-557. https://doi.org/10.1007/s00455-020-10139-6
28. Meister KD, Pandian V, Hillel AT, et al. Multidisciplinary safety recommendations after tracheostomy during COVID-19 pandemic: State of the art review. Otolaryngol Head Neck Surg 2020. https://doi.org/10.1177/0194599820961990
29. Zaga CJ, Pandian V, Brodsky MB, et al. Speech-language pathology guidance for tracheostomy during the COVID-19 pandemic: An international multidisciplinary perspective. Am J Speech Lang Pathol 2020; 29(3): 1320-1334. https://doi.org/10.1044/2020_AJSLP-20-00089
30. McGrath BA, Brenner MJ, Warrillow SJ, et al. Tracheostomy in the COVID-19 era: global and multidisciplinary guidance. Lancet Respir Med 2020 ; 8(7): 717-725. https://doi.org/10.1016/S2213-2600(20)30230-7
31. Mirzakhani H, Williams JN, Mello J, et al. Muscle weakness predicts pharyngeal dysfunction and symptomatic aspiration in long-term ventilated patients. Anesthesiology 2013; 119(2): 389-397. https://doi.org/10.1097/ALN.0b013e31829373fe
32. Tornari C, Surda P, Takhar A, et al. Tracheostomy, ventilatory wean, and decannulation in COVID‑19 patients. Eur Arch Otorhinolaryngol 2020. https://doi.org/10.1007/s00405-020-06187-1
33. Clavé P, Arreola V, Martín A, et al. Basic procedures to assess and treat oropharyngeal dysphagia in patients with COVID-19 infection; 2020.
34. Rameau A, Young VN, Amin MR, Sulica L. Flexible laryngoscopy and COVID-19. Otolaryngol Head Neck Surg 2020. https://doi.org/10.1177/0194599820921395
35. Royal College of Speech and Language Therapists. RCSLT guidance. 2020. Disponible en: https://www.rcslt.org/learning/rcslt- guidance
36. Schindler A, Baijens LWJ, Clavé P, et al. ESSD commentary on dysphagia management during COVID pandemia. Dysphagia 2020; 27: 1-4. https://doi.org/10.1007/s00455-020-10194-z
37. Ku PKM, Holsinger FC, Chan JYK, et al. Management of dysphagia in the patient with head and neck cancer during COVID-19 pandemic: Practical strategy. Head Neck 2020; 42(7): 1491-1496. https://doi.org/10.1002/hed.26224
38. Fritz MA, Howell RJ, Brodsky MB, et al. Moving forward with dysphagia care: implementing strategies during the COVID‐19 pandemic and beyond. Dysphagia 2020; 1-9. https://doi.org/10.1007/s00455-020-10144-9

Artículos más leídos del mismo autor/a