Persons with disorders of consciosness: Are oral feedings safe/effective?

Primary objective: Evaluate the safety and efficacy of providing oral feedings to persons early in coma recovery following a severe brain injury. Research design: Descriptive, retrospective study. Methods and procedures: Medical chart reviews of all patients admitted to a rehabilitation hospital following severe brain injury. Main outcomes and results: Twenty-five patients met the inclusion criteria, 22 had a tracheostomy, and all were NPO. Subjects were divided into two cohorts. Group 1, n = 10, mean age 43.5 years, received oral feedings early in coma recovery. Group 2, n=15, mean age 45.2 years, did not. Group 1, 30% returned to an oral diet of three meals daily at discharge from inpatient rehabilitation as compared to 40% in group 2 (χ² = 0.260, p = 0.610). Average cost of care for group 1 = US$45759 and group 2 = US$41056 (p=0.634). Conclusion: Safe therapeutic oral feedings, in accordance with findings from instrumental swallowing examinations, are possible for patients with disordered consciousness. The therapeutic oral feedings do not significantly increase the cost of care, but the effectiveness of oral feedings early in coma recovery requires further investigation.