Revista CEFAC
https://revistacefac.org.br/article/doi/10.1590/1982-0216/20242612823
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The use of photobiomodulation in swallowing difficulties in individuals who developed the severe form of COVID-19

O uso da fotobiomodulação na dificuldade de deglutição em indivíduos que desenvolveram a forma grave da COVID-19

Aline Diniz Gehren; Daniel Vicentini de Oliveira; Rose Mari Bennemann; Luciana Lozza de Moraes Marchiori; Caio Sabino Ferreira; Caroline Pereira Buturi Arruda; Mariana Zamboni Gasparini

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Abstract

This study aimed to verify the use of photobiomodulation in swallowing difficulties in individuals who had a severe form of COVID-19. This case report was based on a quasi-experimental, quantitative study, with primary data collected from a non-probabilistic sample of 13 adults (aged ≥ 19 to < 60 years) of both sexes, who had the severe form of COVID-19. Swallowing was assessed with the Dysphagia Risk Assessment Protocol, and the intervention used photobiomodulation. Descriptive statistics were used. It was found that all research participants’ risk for dysphagia in water and pudding swallowing tests improved from before to after the intervention. It can be concluded that photobiomodulation had positive results in speech-language-hearing practice to treat swallowing difficulties in adults who were affected by the severe form of COVID-19, intubated, tracheostomized, and needed an alternative feeding route, as the swallowing difficulties improved.

Keywords

COVID-19; Deglutition Disorders; Intubation, Intratracheal; Laser Therapy

Resumo

O objetivo foi verificar o uso da fotobiomodulação na dificuldade de deglutição em  indivíduos que desenvolveram a forma grave da COVID-19. Trata-se de um relato de casos, a partir de um estudo quase experimental, quantitativo, com coleta de dados primários e com amostra não probabilística, realizado com 13 indivíduos adultos (idade ≥ 19 a < 60 anos) de ambos os sexos, que tiveram a forma grave da COVID-19. Foi realizada a avaliação da deglutição pelo Protocolo de Avaliação para o Risco de Disfagia (PARD) e a intervenção com fotobiomodulação. Foi utilizada a estatística descritiva. Verificou-se que todos os participantes da pesquisa apresentaram melhora no risco para disfagia no teste de deglutição de água e de alimento pastoso do momento pré para o pós-intervenção. Pode-se concluir que a utilização da fotobiomodulação na prática fonoaudiológica para tratar a dificuldade de deglutição dos adultos que foram acometidos pela forma grave da COVID-19, intubados, traqueostomizados e necessitaram fazer uso de via alternativa de alimentação, trouxe resultados positivos, com melhora da dificuldade de deglutição.

Palavras-chave

COVID-19; Transtornos da Deglutição; Intubação Intratraqueal; Terapia a Laser

Referências

1. Fabricio MZ, Pacheco-Castilho AC, Pontes-Neto OM, Dantas RO. Clinical swallowing assessment in the diagnosis of silent aspiration. Rev. CEFAC. 2020;22(6):e8420. https://doi.org/10.1590/1982-0216/20202268420

2. Werneck GL, Carvalho MS. The COVID-19 pandemic in Brazil: chronicle of a health crisis foretold. Cad Saude Publica. 2020;36(5). https://doi.org/10.1590/0102-311X00068820 PMID: 32402007

3. Buffon MR, Severo IM, Barcellos RA, Azzolin KO, Lucena AF. Critically ill COVID-19 patients: a sociodemographic and clinical profile and associations between variables and workload. Rev Bras Enferm. 2022;75Suppl 1(Suppl 1):e20210119. https://doi.org/10.1590/0034-7167-2021-0119

4. Fernández-de-Las-Peñas C, Palacios-Ceña D, Gómez-Mayordomo V, Cuadrado ML, Florencio LL. Defining Post-COVID symptoms (post-acute Covid, long Covid, persistent post-Covid): an integrative classification. Int J Environ Res Public Health. 2021;18(5):2621. https://doi.org/10.3390/ijerph18052621

5. Nogueira TL, da Silva SDA, da Silva LH, Leite MVS, da Rocha JFA, Andreza RS. Pós covid-19: as sequelas deixadas pelo Sars-Cov-2 e o impacto na vida das pessoas acometidas. Arch. Health. 2021;2(3):457-71. https://doi.org/10.46919/archv2n3-021

6. Mirzakhani H, Williams JN, Mello J, Joseph S, Meyer MJ, Waak K et al. Muscle weakness predicts pharyngeal dysfunction and symptomatic aspiration in long-term ventilated patients. Anesthesiology. 2013;119(2):389-97. https://doi.org/10.1097/ALN.0b013e31829373fe PMID: 23584384

7. Brodsky MB, Huang M, Shanholtz C, Mendez-Tellez PA, Palmer JB, Colantuoni E et al. Recovery from dysphagia symptoms after oral endotracheal intubation in acute respiratory distress syndrome survivors. A 5-year longitudinal study. Ann Am Thorac Soc. 2017;14(3):376-83. https://doi.org/10.1513/AnnalsATS.201606-455OC

8. Boissier F, Katsahian S, Razazi K, Thille AW, Roche-Campo F, Leon R et al. Prevalence and prognosis of cor pulmonale during protective ventilation for acute respiratory distress syndrome. Intensive Care Med. 2013;39(10):1725-33. https://doi.org/10.1007/s00134-013-2941-9

9. Cândido AF de S, Mello EC de A, Vieira ACAS, Freire EC de A, Lima E de AP, de Vasconcelos ML. Estratégias fonoaudiológicas para o manejo da disfagia em pacientes acometidos por Covid-19: revisão integrativa. REAC. 2020;16:e5366. https://doi.org/10.25248/reac.e5366.2020

10. Chaves R de D, Carvalho CR, Cukier A, Stelmach R, Andrade CR. Symptoms of dysphagia in patients with COPD. J Bras Pneumol. 2011;37(2):176-83. https://doi.org/10.1590/s1806-37132011000200007

11. Vergara J, Skoretz SA, Brodsky MB, Miles A, Langmore SE, Wallace S et al. Assessment, diagnosis, and treatment of dysphagia in patients infected with SARS-CoV-2: a review of the literature and international guidelines. Am J Speech Lang Pathol. 2020;29(4):2242-53. https://doi.org/10.1044/2020_AJSLP-20-00163

12. Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A et al. Neurological associations of COVID-19. Lancet Neurol. 2020;19(9):767-83. https://doi.org/10.1016/S1474-4422(20)30221-0 PMID: 32622375

13. De Lima Bezerra PC, Ribeiro De Lima LC, Dantas SC. Covid-19 pandemic and the elderly as risk population: aspects for health education. Cogitare Enfermagem. 2020;25:1-9. https://doi.org/10.5380/ce.v25i0.73307

14. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q et al. Neurologic manifestations of hospitalized patients with Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683-90. https://doi.org/10.1001/jamaneurol.2020.1127 PMID: 32275288

15. Frajkova Z, Tedla M, Tedlova E, Suchankova M, Geneid A. Postintubation dysphagia during COVID-19 outbreak-contemporary review. Dysphagia. 2020;35(4):549-57. https://doi.org/10.1007/s00455-020-10139-6 PMID: 32468193

16. Coutts KA. Dysphagia services in the era of COVID-19: Are speech-language therapists essential? S Afr J Commun Disord. 2020;67. https://doi.org/ 10.4102/sajcd.v67i1.709 PMID: 32787417

17. Grilli GM, Giancaspro R, Del Colle A, Quarato CMI, Lacedonia D, Barbaro MPF et al. Dysphagia in non-intubated patients affected by COVID-19 infection. Eur Arch Otorhinolaryngol. 2022;279(2):507-13. https://doi.org/10.1007/s00405-021-07062-3 PMID: 34468824

18. De Vincentis G, Ferrari C, Guerini Rocco D. Severe oropharyngeal dysphagia following COVID-19: a case report. Clin Case Rep. 2021;9(3):1539-43. https://doi.org/10.1002/ccr3.3819

19. Nascimento Júnior JR, Ceron CF, Signorini AV, Klein AB, Castelli CTR, Silvério CC et al. Dysphagia occurrence in COVID-19-positive patients in two hospitals in Brazil. Arq Gastroenterol. 2022;29(3):439-46. https://doi.org/10.1590/S0004-2803.202203000-78 PMID: 36102445

20. Tanaka PP, Pessoa R, Fernandes R, Brodsky J. O que falta para o manejo de via aérea difícil no século 21. Rev Bras Anestesiol. 2015;65(3):235-6. https://doi.org/10.1016/j.bjane.2013.11.008

21. Bhatraju PK, Ghassemieh BJ, Nichols M, Kim R, Jerome KR, Nalla AK et al. Covid-19 in Critically Ill Patients in the Seattle Region - Case Series. N Engl J Med. 2020;382(21):2012-22. https://doi.org/10.1056/NEJMoa2004500 PMID: 32227758

22. Turri-Zanoni M, Battaglia P, Czaczkes C, Pelosi P, Castelnuovo P, Cabrini L. Elective tracheostomy during mechanical ventilation in patients affected by COVID-19: preliminary case series from Lombardy, Italy. Otolaryngol Head Neck Surg. 2020;163(1):135-7. https://doi.org/10.1177/0194599820928963 PMID: 32396455

23. Takhar A, Walker A, Tricklebank S, Wyncoll D, Hart N, Jacob T et al. Recommendation of a practical guideline for safe tracheostomy during the COVID-19 pandemic. Eur Arch Otorhinolaryngol. 2020;277(8):2173-84. https://doi.org/10.1007/s00405-020-05993-x PMID: 32314050

24. Correia PRB, Coêlho JF, Freire MLJ, Almeida LNA, Pernambuco LA, Alves GÂ dos S. Photobiomodulation in speech-language-hearing therapy: a profile of professional practice and the level of information of Brazilian speech-language-hearing therapists. Rev. CEFAC. 2021;23(3):e12920. https://doi.org/10.1590/1982-0216/202123312920

25. Ferraresi C, Kaippert B, Avci P, Huang YY, de Sousa MV, Bagnato VS et al. Low-level laser (light) therapy increases mitochondrial membrane potential and ATP synthesis in C2C12 myotubes with a peak response at 3-6 h. Photochem Photobiol. 2015;91(2):411-6. https://doi.org/10.1111/php.12397

26. Bacelete VSB, Gama ACC. Therapeutic effects of photobiomodulation in the speech-language-hearing clinic: an integrative literature review. Rev. CEFAC. 2021;23(1):e9120. https://doi.org/10.1590/1982-0216/20212319120

27. Nejatifard M, Asefi S, Jamali R, Hamblin MR, Fekrazad R. Probable positive effects of photobiomodulation as an adjunctive treatment in COVID-19: a systematic review. Cytokine. 2021;137. https://doi.org/10.1016/j.cyto.2020.155312 PMID: 33128927

28. Gomes CF, Schapochnik A. The therapeutic use of low intensity laser (LLLT) in some diseases and its relation to the performance in speech therapy. Distúrb. Comunic. 2017;29(3):570-8. https://doi.org/10.23925/2176-2724.2017v29i3p570-578

29. Leal Junior ECP, Lopes-Martins RÁB, Frigo L, De Marchi T, Rossi RP, Godoi V et al. Effects of Low-Level Laser Therapy (LLLT) in the development of exercise-induced skeletal muscle fatigue and changes in biochemical markers related to postexercise recovery. J Orthop Sports Phys Ther. 2010;40(8):524-32. https://doi.org/10.2519/jospt.2010.3294 PMID: 20436237

30. Matos AS de, Berretin-Felix G, Bandeira RN, Lima JAS de, Almeida LNA, Alves GÂ dos S. Laser therapy applied to orofacial motricity: perception of members of the Brazilian Orofacial Motricity Association - Abramo. Rev. CEFAC. 2018;20(1):61-8. https://doi.org/10.1590/1982-021620182017317

31. Alves VMN, Furlan RMMM, Motta AR. Immediate effects of photobiomodulation with low-level laser therapy on muscle performance: an integrative literature review. Rev. CEFAC. 2019;21(4):e12019. https://doi.org/10.1590/1982-0216/201921412019

32. Leal-Junior EC, Vanin AA, Miranda EF, de Carvalho P de T, Dal Corso S, Bjordal JM. Effect of phototherapy (low-level laser therapy and light-emitting diode therapy) on exercise performance and markers of exercise recovery: a systematic review with meta-analysis. Lasers Med Sci. 2015;30(2):925-39. https://doi.org/10.1007/s10103-013-1465-4 PMID: 24249354

33. Vanin AA, Miranda EF, Machado CS, de Paiva PR, Albuquerque-Pontes GM, Casalechi HL et al. What is the best moment to apply phototherapy when associated to a strength training program? A randomized, double-blinded, placebo-controlled trial: phototherapy in association to strength training. Lasers Med Sci. 2016;31(8):1555-64. https://doi.org/10.1007/s10103-016-2015-7 PMID: 27371449

34. Henriques Á, Cazal C, De Castro J. Ação da laserterapia no processo de proliferação e diferenciação celular, Revisão da literatura. Rev. Col. Bras. 2010;37(4):295-302. https://doi.org/10.1590/S0100-69912010000400011

35. Padovani AR, Moraes DP, Mangili LD, Andrade CRF. Protocolo Fonoaudiológico de Avaliação do Risco para Disfagia (PARD). Rev Soc Bras Fonoaudiol. 2007;12(3):199-205. https://doi.org/10.1590/S1516-80342007000300007

36. ABC D. Therapy EC | DMC ABC | Laserterapia. 2020;[S.l: s.n.]. Disponível em: https://dmcabc.com.br/produto/laser-dmc-therapy-ec/

37. Ferreira SL de S, Cunha DA da, Almeida ANS de, Cunha MD da, Bastos RS de A, Silva HJ da. The use of photobiomodulation for the muscles of head and neck: an integrative review. Audiol., Commun. Res. 2021;26:e2552. https://doi.org/10.1590/2317-6431-2021-2552

38. Rocha JCT. Terapia laser, cicatrização tecidual e angiogenese. Revista Brasileira em Promoção da Saúde. 2004;17(1):44-8. https://doi.org/10.5020/345

39. Leal Junior EC, Lopes-Martins RA, Frigo L, De Marchi T, Rossi RP, de Godoi V et al. Effects of low-level laser therapy (LLLT) in the development of exercise-induced skeletal muscle fatigue and changes in biochemical markers related to postexercise recovery. J Orthop Sports Phys Ther. 2010;40(8):524-32. https://doi.org/ 10.2519/jospt.2010.3294

40. Reddy GK. Photobiological basis and clinical role of low-intensity lasers in biology and medicine. J Clin Laser Med Surg. 2004;22(2):141-50. https://doi.org/ 10.1089/104454704774076208. PMID: 15165389

41. Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci. 2020;11(7):995-8. https://doi.org/10.1021/acschemneuro.0c00122 PMID: 32167747

42. Orser BA. Recommendations for endotracheal intubation of COVID-19 patients. Anesth Analg. 2020;130(5):1109-10. https://doi.org/10.1213/ANE.0000000000004803 PMID: 32209810

43. Silva AWC, Cunha AA, Alves GC, Corona RA, Dias CAGM, Nassiri R et al. Perfil epidemiológico e determinante social do COVID-19 em Macapá, Amapá, Amazônia, Brasil. Revista Científica Multidisciplinar Núcleo do Conhecimento. 2020;4(4): Disponível em: https://doi.org/10.32749/nucleodoconhecimento.com.br/saude/covid-19-em-macapa

44. Ozaki K, Kagaya H, Yokoyama M, Saitoh E, Okada S, González-Fernández M et al. The risk of penetration or aspiration during videofluoroscopic examination of swallowing varies depending on food types. Tohoku J Exp Med. 2010;220(1):41-6. https://doi.org/10.1620/tjem.220.41 PMID: 20046051.

45. Steele CM, Molfenter SM, Péladeau-Pigeon M, Polacco RC, Yee C. Variations in tongue-palate swallowing pressures when swallowing xanthan gum-thickened liquids. Dysphagia. 2014;29(6):678-84. https://doi.org/10.1007/s00455-014-9561-6 PMID: 25087111

46. Ashida I, Miyaoka S, Miyaoka Y. Comparison of video-recorded laryngeal movements during swallowing by normal young men with piezoelectric sensor and electromyographic signals. J Med Eng Technol. 2009;33(6):496-501. https://doi.org/10.1080/03091900902952691

47. Tsukada T, Taniguchi H, Ootaki S, Yamada Y, Inoue M. Effects of food texture and head posture on oropharyngeal swallowing. J Appl Physiol (1985). 2009;106(6):1848-57. https://doi.org/10.1152/japplphysiol.91295.2008 PMID: 19325027

48. Gonçalves BF da T, Bastilha GR, Costa C da C, Mancopes R. Use of protocols for quality of life in dysphagia: literature review. Rev. CEFAC. 2015;17(4):1333-40. https://doi.org/10.1590/1982-0216201517418014

49. Smithard DG. Neuromuscular disease and extubation dysphagia. Crit Care. 2013;17(5):194. https://doi.org/10.1186/cc12762 PMID: 24099408

50. Schefold JC, Berger D, Zürcher P, Lensch M, Perren A, Jakob et al. Dysphagia in Mechanically Ventilated ICU Patients (DYnAMICS): a prospective observational trial. Crit Care Med. 2017;45(12):2061-9. https://doi.org/10.1097/CCM.0000000000002765 PMID: 29023260
 


Submetido em:
20/05/2023

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24/10/2023

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