Thickened fluid adequacy and compliance in Stroke/Neurology patients

Sierp, E.1, Green, M.1, Maurici, T.1.

1Royal Adelaide Hospital, CALHN, SA Health

 

Background and aims: Swallowing disorders are a common deficit post stroke and neurological diseases. Thickened fluids have been associated with reduced oral intake, increased risk of malnutrition/dehydration resulting in poor recovery, increased length of acute hospital stay and delayed transition to rehabilitation. This project aims to identify the adequacy and barriers of thickened fluid consumption in stroke/neurology patients admitted to the Royal Adelaide Hospital (RAH).

Methods: An observational study of 22 patients who were admitted to the stroke/neurology unit at the RAH, commenced on thickened fluids and were for active treatment. Patient fluid consumption and estimated fluid requirements (25 ml/kg/day) were calculated by the treating dietitian. A survey detailing barriers to fluid consumption was conducted on the patient or to family/nurses if patient cognition was impaired.

Results: Ten (45%) patients required mildly thick fluids and 12 (54%) patients required moderately thick, no patients received extremely thick fluids. The average oral fluid consumption was 685 (±13.53) ml/day, averaging 35.6% (±275.4) of estimated requirements. Eleven patients (50%) met 0-≤25%, 7 (31.8%) met 25.1-50%, 3 (13.7%) met 50.1-75%, and 1 (4.5%) met 75.1-100% of their estimated fluid requirements orally. Consequently, 16 (72%) patients required supplemental enteral feeding. Barriers to consumption included feeding assistance (n=5, 26%), fatigue or dislike of the fluids (n=4, 21%), and early satiety and confusion/alertness (n=3, 15%).

Conclusion: Stroke/neurology patients on thickened fluids do not meet their estimated fluid requirements orally and are at risk of dehydration with numerous barriers to consumption. Strategies to improve these outcomes should be considered.


Miranda Green

Miranda Green is a Clinical Dietitian in Critical Care at the Royal Adelaide Hospital with an interest in contributing to the improvement on nutritional status of individuals during their acute admission. Commencing her career at the Royal Adelaide Hospital as the new graduate dietitian in 2019 Miranda is continuing her clinical profession in intensive and critical care in 2020. Miranda aims to continue developing efficient procedure pathways to optimise nutrition at the Royal Adelaide Hospital. In her spare time Miranda enjoys kitesurfing at local Adelaide beaches and the Yorke Peninsula.

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