Quantifying fluid intake in dysphagic stroke patients: A preliminary comparison of oral and nonoral strategies

Finestone HM, Foley NC, Woodbury MG, Greene-Finestone L. Quantifying fluid intake in dysphagic stroke patients: a preliminary comparison of oral and nonoral strategies. Arch Phys Med Rehabil 2001;82:1744-6. Objective: To determine whether dysphagic stroke patients receiving oral (thickened-fluid dysphagia) diets or nonoral (enteral feedings supplemented with intravenous fluids) diets met their estimated fluid requirements. Design: Cohort study. Setting: University-affiliated hospital. Participants: Thirteen dysphagic patients with new strokes were studied for 21 days postadmission to hospital. Interventions: Seven patients (group 1) were started on nonoral feeding and later progressed to oral diets and 6 patients (group 2) received oral dysphagia diets only. Main Outcome Measure: Fluid intake. Results: Fluid intake of patients in group 1 significantly declined over the 21 days (mean ± standard deviation, 3158 ± 523mL/d vs 984 ± 486mL/d; p < .0001), representing 134% ± 26% and 43% ± 20% of their fluid requirements, respectively. Mean fluid intake of patients in group 2 was 755 ± 162mL/d, representing 33% ± 5% of requirements. This volume was significantly lower than the fluid intake of patients who received nonoral feeding (p < .0001). Conclusions: Dysphagic stroke patients who received thickened-fluid dysphagia diets failed to meet their fluid requirements whereas patients on enteral feeding and intravenous fluid regimens received ample fluid. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation