How is dehydration managed in patients with dysphagia?

Updated: Mar 20, 2020
  • Author: Nam-Jong Paik, MD, PhD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Because fluid intake is restricted in most patients with dysphagia, these individuals are at risk of dehydration. Therefore, the patient's hydration status must be closely monitored. Dehydration may lead to lethargy, mental confusion, and increased aspiration. In addition, dehydration depresses the immune system, making the patient susceptible to infection, and it may also be a risk factor for pneumonia, because it decreases salivary flow (thus promoting altered microbial colonization of the oropharynx).

The hydration state of a patient can be assessed by using input and output records, laboratory values (eg, serum osmolality), and physical indicators (eg, dry mucous membranes, poor skin turgor, darkened urine).

Adequate fluid intake can be achieved through simple interventions, such as systematically offering patients preferred liquids or foods with high fluid content (eg, pureed fruits and vegetables, hot cereals, custards, puddings) and having an adequate number of supervised staff to help patients drink while properly positioned. Intravenous fluids or water boluses given via a feeding tube may be necessary if hydration cannot be maintained.

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