GUIDELINES FOR EARLY DETECTION, DIAGNOSTICS AND THERAPY OF NEUROGENIC OROPHARYNGEAL DYSPHAGIA
Zdravka Poljaković, Dinah Vodanović, Darija Vranešić Bender, Dina Ljubas Kelečić, Katarina Starčević, Zdravko Kolundžić, Marina Bedeković Roje, Mihael Mišir, Sanja Habus, Željko Krznarić
Guidelines for the early detection, diagnostics and therapy of neurogenic oropharyngeal dysphagia have been made as a result of collaboration of clinicians of different backgrounds who are dealing with patients with neurogenic oropharyngeal dysphagia (NOD). These guidelines have been written by the representatives of the Croatian Society of Clinical Nutrition, Croatian Medical Association, Croatian Neurological Society, Croatian Medical Association, Croatian Society of Gastroenterology and Croatian Society of Nutritionists and Dietitians. The aim of these guidelines is to raise the awareness about NOD that is encountered in acute and chronic neurological diseases, especially in patients with stroke, extrapyramidal diseases, neuromuscular and demyelinisation diseases and dementia. We provide a detailed description of diagnostics of dysphagia, and we recommend the establishment of a multidisciplinary team for dysphagia involving neurologists, internists, speech therapists, dietitians, pharmacists and nurses with special competences for the management of NOD. An educated team member conducts diagnostics and rehabilitation in accordance with the validated tools, classifications and categorizations shown in these guidelines to allow a systematic and consistent treatment. The guidelines also provide detailed algorithms for introducing nutritional support – from the application of modified texture foods, proper hydration to artificial nutrition (enteral and parenteral nutrition).