EARLY SPEECH AND LANGUAGE THERAPY INTERVENTION IN COVID-19 PATIENTS IN INTENSIVE CARE UNIT: CASE REPORT

Abstract

INTRODUCTION: This present work demonstrates the role of the speech and language therapy in the Intensive Care Unit (ICU), who facilitates the swallowing evolution of the tracheostomized (TQT) patient by contributing interdisciplinary to weaning, decannulation and post-COVID-19 recovery. ¹³

CASE PRESENTATION: 34-year-old man with smoking history. Admitted with dyspnea with subsequent diagnosis of SARS-CoV2 pneumonia.  Mechanical ventilation (MV) and TQT was required. Speech and language therapy goals: restoration of oropharyngeal pressure and sensitivity, injection of compressed air through the subglottic port, stimulation of non-nutritive swallowing, maintenance of airway protection thresholds (VA), speaking valve (SV) use and occlusion of TQT.^{8 – 13}

An alternative communication system was adapted and was planned a treatment with a daily intervention. The beginning assess intervention contemplate the deflation tolerance of the pneumotaponation balloon and the placement of the SV. The Blue Dye Test (BDT) was performed, with immediate negative and delayed positive results. We continue with short periods of SV and subsequent negative BDTs. Once weaned from MV, was performed modified BDTs with semisolid consistency with negative results. TQT cannula occlusion was performed for 48 hours with adequate tolerance. Patient decannulated without complications and began mixed feeding.

CONCLUSION: Early intervention in patients who suffer from SARS-CoV2 infections and who must be intubated and tracheostomized requires a multidisciplinary approach.¹ The speech and language therapy improves the detection and monitoring of risks to swallowing safety and efficacy and, therefore, both phonatory and swallowing functions are restored and communication is prioritized.