PP338 - FROM MECHANICAL SURVIVAL TO HUMAN EATING: ORAL TRANSITION, SARCOPENIA, AND MALNUTRITION IN POST-ICU RECOVERY
PP338
FROM MECHANICAL SURVIVAL TO HUMAN EATING: ORAL TRANSITION, SARCOPENIA, AND MALNUTRITION IN POST-ICU RECOVERY
Z. Irmak Kaya1,*, B. Ak Gencel2
1Internal Medicine, 2Eskişehir Şehir Hastanesi, Eskişehir, Türkiye
Rationale: Post-extubation dysphagia(PED) hinders nutritional recovery, yet its lived experience and link to sarcopenia are poorly understood. We investigated oral transition experiences and their associations with muscle strength, malnutrition, and symptom distress in patients transitioning from intensive care.
Methods: A convergent parallel mixed-methods study prospectively assessed 50 post-mechanical ventilation patients in a post-acute unit using Handgrip Strength(HGS), GLIM, EAT-10, and Edmonton Symptom Assessment System (ESAS) at Day 1 and 7. Concurrently, 15 purposively selected patients underwent Heideggerian interpretive phenomenological interviews. Qualitative data, analyzed via Colaizzi’s method, were integrated with quantitative findings at the interpretation level to triangulate functional and psychosocial recovery.
Results: By Day 7, 64% of patients met ≥75% of energy targets. Significant improvements occurred in HGS (14.8±3.2 to 17.5±2.9kg,d=0.92), EAT-10 (27.2±4.5 to 13.8±3.1,d=1.24), and ESAS distress (p<0.01). HGS gain independently predicted success (OR=1.42,p<0.001), while severe malnutrition (GLIM Stage2) significantly reduced success odds compared to moderate cases (OR=0.34,p=0.005). Qualitative themes (1) 'Return to Humanity,' (2) 'Phagophobic Paralysis,' and (3) 'Sensory Alienation', closely aligned with clinical findings: low HGS matched a 'mechanized body perception,' while high EAT-10 reflected 'phagophobic paralysis.' No oral feeding-related adverse events occurred.
Conclusion: Post-ICU oral transition is not merely functional but also a deeply meaningful psychosocial process. HGS is a practical clinical biomarker of sarcopenic dysphagia and recovery potential. Early identification of low HGS, combined with psychosocial support for choking-related fear, may guide targeted nutritional and rehabilitative strategies to restore patients’ sense of humanity through eating.
Disclosure of Interest: None declared