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

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 I significantly declined over the 21 days (mean standard deviation, 3158 +/- 523mL/d vs 984 +/- 486mL/d; p < .0001), repressing 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.