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Dysphagiemanagement in der akuten Schlaganfallphase

Management of dysphagic patients with acute stroke

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An Erratum to this article was published on 15 February 2013

Zusammenfassung

Diese Expertenempfehlungen beschreiben das Dysphagiemanagement in der akuten Schlaganfallphase, wobei das Hauptziel die Minimierung des Risikos von Aspirationspneumonien (AP) darstellt. So früh wie möglich soll durch Pflegepersonen oder Ärzte das standardisierte Schluckassessment (SSA) durchgeführt werden. Danach erfolgen durch Sprachtherapeuten/Logopäden klinische Schluckuntersuchungen, bestehend aus der Erfassung von Aspirations- und AP-Prädiktoren sowie von faziooralen und pharyngolaryngealen Funktionen. Abhängig vom Ergebnis dieser Untersuchungen ist eine Videoendoskopie oder Videofluoroskopie des Schluckens indiziert. Basierend auf diesen Befunden kann u. a. die Indikation zur Oralisierung oder enteralen Ernährung gestellt werden; das AP-Risiko kann minimiert werden. Als Entscheidungshilfen für das diagnostische und therapeutische Vorgehen werden Algorithmen präsentiert.

Summary

This article describes expert recommendations on the management of patients with acute stroke, who might suffer from dysphagia. The main goal is to reduce the risk of aspiration pneumonia (AP). Nurses or physicians should perform the standardized swallowing assessment (SSA) as soon as possible and speech-language therapists have to perform examinations comprising assessment of predictors for aspiration and for AP as well as the clinical swallowing assessment. Dependent on the results, flexible endoscopic or video fluoroscopic evaluation of swallowing has to be performed so that indications for enteral or oral feeding can be made. Furthermore, the risk of AP can be minimized. This article presents algorithms which enable decision-making with regard to diagnostic and therapeutic measures.

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Authors and Affiliations

  1. Abteilung Neurologie und Neuropsychologie mit Zentrum für Schluckstörungen, m&i Fachklinik Bad Heilbrunn, Wörnerweg 30, 83670, Bad Heilbrunn, Deutschland

    M. Prosiegel

  2. Klinik für Neurologie, Universitäts- und Rehabilitationskliniken Ulm (RKU), Ulm, Deutschland

    A. Riecker

  3. Kölner Dysphagiezentrum, Köln, Deutschland

    M. Weinert

  4. Klinik für Neurologie, Universitätsklinikum Münster, Münster, Deutschland

    R. Dziewas & T. Warnecke

  5. Abteilung Logopädie, Universitäts- und Rehabilitationskliniken Ulm (RKU), Ulm, Deutschland

    B. Lindner-Pfleghar

  6. Abteilung Logopädie & Karlsbader Schluckzentrum, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Deutschland

    S. Stanschus

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  1. M. Prosiegel
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  2. A. Riecker
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  3. M. Weinert
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  4. R. Dziewas
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  5. B. Lindner-Pfleghar
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  6. S. Stanschus
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  7. T. Warnecke
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Correspondence to M. Prosiegel.

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Prosiegel, M., Riecker, A., Weinert, M. et al. Dysphagiemanagement in der akuten Schlaganfallphase. Nervenarzt 83, 1590–1599 (2012). https://doi.org/10.1007/s00115-012-3679-2

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  • DOI: https://doi.org/10.1007/s00115-012-3679-2

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