Alterações na deglutição e suas associações com a gravidade da doença pulmonar e estado nutricional em pacientes com fibrose pulmonar idiopática

Abstract

The aim of this study was to identify swallowing alterations using EAT-10, TWST, TOMASS, and tongue pressure measurement, and their associations with the severity of lung disease in patients with idiopathic pulmonary fibrosis (IPF). The research aimed to identify, through specific questionnaires for the assessment of swallowing and nutritional status, tongue dorsum pressure measurement, swallowing alterations, and their associations with the severity of pulmonary disease in patients with IPF. The methodology involved the assessment of patients diagnosed with IPF who were followed up at the Interstitial Lung Disease Clinic of Piquet Carneiro Polyclinic/University of the State of Rio de Janeiro. They underwent the Modified Medical Research Council questionnaire (MRCm), Mini Nutritional Assessment Short Form (MNA-SF), and Eating Assessment Tool (EAT-10) questionnaires, as well as swallowing evaluation through the Timed Water Swallow Test (TWST) and Test of Mastication and Swallowing Solids (TOMASS). Tongue pressure was measured, and spirometry, carbon monoxide diffusing capacity measurement (DLCO), and maximum inspiratory and expiratory pressure measurements were performed. The results included a sample of 34 individuals, with 52.9% of them experiencing dyspnea and mild to moderate restrictive impairment in 52.9%. There was a significant association between nutritional assessment and the need for oxygen therapy (p=0.01) and the presence of dietary adaptations (p=0.02). We found an association between liquid swallowing assessment data and DLCO (p=0.03). Some TOMASS indices (p=0.04 and p=0.03) were related to the degree of dyspnea. The number of swallows per bite was associated with tongue dorsum pressure measurement (p=0.02). In conclusion, the severity of IPF is related to changes in nutritional status, the need for dietary adaptations, and liquid swallowing. Patients with mild to moderate disease are already at risk for swallowing safety