Effect and Safety of Oral Desmopressin for Nocturia in Brain Injured Patients

OBJECTIVE: To assess the effect of oral desmopressin administration for nocturia and sleeping in brain injured patients and to confirm its safety. METHOD: 20 brain injured patients waking up more than twice a night for urination during sleeping have been subjected to take 0.1 mg of desmopressin at 9 p.m. everyday for 30 days. To analyze the effect of the drug before and after its administration, the frequency of patient's awakening for urination, duration of time to first urination after sleeping, total urination volume during sleeping and Pittsburgh sleep quality index (PSQI) were evaluated. All newly found symptoms one month after taking the medication were recorded to confirm the safety of the drug. RESULTS: After taking the medication, the mean urination frequency of 20 patients was reduced from 2.4 to 1.4, the mean duration of time to the first urination after sleeping was increased from 3.4 hours to 4.9 hours (p<0.01). The mean PSQI score of 20 patients was decreased from 9.7 to 4.8 (p<0.01). 2 patients had side effects (hyponatremia, headache). CONCLUSION: The oral administration of desmopressin was relatively safe and effective on brain injured patients with nocturia.

Swallowing Pattern according to Controlled Food Viscosity in Patients with Brain Lesion

OBJECTIVE: The response of the pharyngeal phase during swallowing is influenced by various factors including viscosity, shape, firmness, fracturability, and cohesive power. These factors affect the pharyngeal phase simultaneously, but little research has been conducted into their individual effects on the pharyngeal phase. This study investigated the relationship between controlled viscosity and pharyngeal transit time (PTT). METHOD: The subjects were 81 patients with naso-gastric tube due to brain dysfunction. PTT was assessed by video- esophageal fluoroscopy and the viscosity of the processed starch by Brookfield viscometer. High viscosity was defined as a controlled viscosity of 12% and 9%, medium viscosity as a controlled viscosity of 7.5%, 6%, and 4.5%, and low viscosity as a controlled viscosity of 3%, 1.5%, and 0% (liquid viscosity). RESULTS: PTT was prolonged with increasing viscosity in the experimental group. There were no significant differences between PTT of the experimental and control groups at any viscosity. Aspiration prevalence was 1.85%, 7.82%, and 22.22% in the high, medium, and low viscosity groups, respectively, and the three prevalences showed significant differences. CONCLUSION: PTT showed a tendency to be prolonged with increasing food viscosity in the experimental group.