Effects of oral ingestion on physical functions before tube feeding in adults with severe motor and intellectual disabilities

• Published in: Odontology 2019-07, Vol.107 (3), p.368-373
• Main Authors: Nakazawa, Yujiro, Tamura, Fumiyo, Genkai, Sae, Shindo, Hiroki, Isoda, Tomoko, Mizukami, Miki, Kikutani, Takeshi
• Format: Article
• Language: English
• Subjects: Blood flow; Cerebral blood flow; Dentistry; Dysphagia; Enteral nutrition; Feeding; Fluoridation; Infrared spectroscopy; Intellectual disabilities; Medicine; Oral and Maxillofacial Surgery; Original Article
• ISSN: 1618-1247; 1618-1255
• DOI: 10.1007/s10266-018-0396-8

This study aimed to determine the significance of oral ingestion in tube-fed adults. Six males and three females (mean age 48.1 ± 12.4 years) with severe motor and intellectual disabilities were included in this study. The subjects were monitored for cerebral blood flow (CBF) by functional near-infrared spectroscopy imaging, gastric motor function by electrogastrography, and arterial oxygen saturation (SpO 2 ) and pulse rate with a biological data monitoring device. The subjects were divided into two groups, settings A and B. In setting A, after resting for 30 min, the subjects were tube fed a routinely used enteral nutrient solution. In Setting B, the subjects received 10 cc of thickened enteral nutrient solution prior to tube feeding. Cerebral function as measured by CBF significantly increased after tube feeding under setting A (without oral ingestion), as compared to the resting state. Under setting B (with oral ingestion), CBF significantly increased after oral ingestion and after tube feeding. SpO 2 significantly decreased under setting B after oral ingestion and after tube feeding. Gastric motor function showed no significant change after tube feeding in either setting. The pulse rate significantly increased before tube feeding as compared to that in the resting state, after feeding as compared to before feeding and after feeding as compared to the resting state. Our data suggest that introducing oral ingestion, at least partially, in tube-fed individuals with severe dysphagia is beneficial in that it can stimulate cerebral function.