Inadequate fluid intakes in dysphagic acute stroke

Background and Aims: To investigate the fluid intakes of patients with dysp hagic acute stroke and to evaluate the effect of disability, the ward speci ality and the type of fluid given on oral intake. Methods: Patients were pr ospectively recruited and randomly assigned to receive powder-thickened flu ids or ready prepared pre-thickened fluids. Parenteral, enteral and oral fl uid intakes, urine output, clinical sequelae and the frequency of requests for biochemical measures of hydration were recorded for a maximum of fourte en days. Results: 24 patients with dysphagic acute stroke requiring thicken ed fluids were recruited from a large teaching hospital. Mean thickened flu id 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 to tal intake due to insufficient volumes being given for too short a period. Patients not on specialist stroke units who received pre-thickened fluids d rank almost 100% more than those on powder-thickened fluids (P=0.04). Concl usions: Fluid intakes in this patient group are insufficient to achieve req uirements. Hospital staff must ensure adequate fluid intakes in patients at risk of dehydration, which should include both an adequate prescription an d provision of supplementary fluids. Pre-thickened drinks improve oral flui d intake in patients with dysphagic acute stroke on non-specialist wards. ( C) 2001 Harcourt Publishers Ltd.