Inadequate fluid intakes in dysphagic acute stroke

Abstract

Background and aims: To investigate the fluid intakes of patients with dysphagic acute stroke and to evaluate the effect of disability, the ward speciality and the type of fluid given on oral intake.

Methods: Patients were prospectively recruited and randomly assigned to receive powder-thickened fluids or ready prepared pre-thickened fluids. Parenteral, enteral and oral fluid intakes, urine output, clinical sequelae and the frequency of requests for biochemical measures of hydration were recorded for a maximum of fourteen days.

Results: 24 patients with dysphagic acute stroke requiring thickened fluids were recruited from a large teaching hospital. Mean thickened fluid intake was 455 ml/d (SEM+/-70) resulting in the use of an extra 742 ml/d (+/-132) of supplementary fluids. This did not result in an adequate total intake due to insufficient volumes being given for too short a period. Patients not on specialist stroke units who received pre-thickened fluids drank almost 100% more than those on powder-thickened fluids (P=0.04).

Conclusions: Fluid intakes in this patient group are insufficient to achieve requirements. Hospital staff must ensure adequate fluid intakes in patients at risk of dehydration, which should include both an adequate prescription and provision of supplementary fluids. Pre-thickened drinks improve oral fluid intake in patients with dysphagic acute stroke on non-specialist wards.