Patients With Thin-Liquid Dysphagia Benefit From Free Water Protocol at LTACH

A protocol trial that allowed a small group of patients with thin-liquid dysphagia to freely consume thin liquid water at a long-term acute care hospital (LTACH) led to improved hydration, quality of life, and overall swallow function, with no cases of aspiration pneumonia, according to a study published in Scientific Reports. 

“The results in this feasibility study allowed for the hospital-wide implementation of the free water protocol and laid out the groundwork for future studies looking at longitudinal effects of a free water protocol,” wrote corresponding author Henry C. Hrdlicka, PhD, of the Milne Institute for Healthcare Innovation at Gaylord Specialty Healthcare, Wallingford, Connecticut, and coauthors.

The study enrolled 10 patients, nine of whom had sufficient data for analysis. Participants’ admitting diagnoses included stroke, acute respiratory failure, multi-trauma, and spinal cord injury. Over the 7-day trial, staff used inventories, lab work, and observation to track patients’ fluid intake, hydration status, quality of life, and overall swallow function. Participants were followed for adverse events for a period beyond the trial.

No adverse events, including aspiration pneumonia, occurred, according to the study. Moreover, fluid intake, functional eating ability, and quality of life improved significantly with the free water protocol.

“In this study, our primary goal was to determine the feasibility of implementing a free water protocol in the LTACH setting,” researchers wrote. “Our results show that, with the inclusion of a diverse interdisciplinary team, hospital-wide acceptance and implementation of the free water protocol was achievable.”

Reference:
Gaidos S, Hrdlicka HC, Corbett J. Implementation of a free water protocol at a long term acute care hospital. Sci Rep. 2023;13(1):2626. doi:10.1038/s41598-023-29448-5