Complementary Speech and Respiratory Intervention in DOC Patients Decannulation
Manuela Locatelli, Alessandra Cima
Disorders of Consciousness (DOC) may occur in severe Acquired Brain Injury (sABI), with brainstem lesions, severe and diffuse bihemispheric lesions, as well as haemorrhagic damage. Subjects with DOC are extremely complex in rehabilitative management, due to poor collaboration, a compromised clinical-respiratory diagnosis and fluctuation in performances. The removal of the tracheostomy tube is one of the main rehabilitative aims, from the acute to outcome phases, but literature doesn’t give specific guidelines regarding the coordination between the speech-language pathologist and the respiratory therapist in managing patients with DOC. Different authors’ approaches thus need to be analysed and reviewed from an interdisciplinary perspective. In this paper, starting from literature and our daily experience, we sum up respiratory and swallowing damage in DOC patients; we also explain two case reports that underline the importance of interdisciplinary collaboration in tracheostomy weaning. This can only be done through the coordinated work of the speech-language pathologist and the respiratory therapist, leading not only to an improvement in respiratory and swallowing patterns, but also to a positive impact on cognitive and motor performance.
Keywords
sABI, Decannulation, Swallowing, Speech-language pathologist, Respiratory therapist.
