Comparison of 2 Interventions for Liquid Aspiration on Pneumonia Incidence

Robbins, JoAnne; Gensler, Gary; Hind, Jacqueline; Logemann, Jeri A.; Lindblad, Anne S.; Brandt, Diane; Baum, Herbert M.; Lilienfeld, David E.; Kosek, Steven; Lundy, Donna S.; Dikeman, Karen; Kazandjian, Marta; Gramigna, Gary D.; McGarvey-Toler, Susan; Gardner, Patricia J. Miller

doi:10.7326/0003-4819-148-7-200804010-00007

Cited by 277 publications

(286 citation statements)

References 30 publications

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“…These results are of great clinical relevance in light of published data indicating that patients who aspirated the more viscous 3,000 cP fluids and contracted pneumonia had hospital stays three times longer than those who aspirated the less viscous nectar fluid [12]. Longer hospital stays may have been precipitated by the 3,000 cP fluid being more viscous and having a higher yield stress and, therefore, being more difficult to clear from the airway than less viscous liquids [13].…”

Section: Discussionmentioning

confidence: 61%

“…However, significantly fewer patients rated honey barium as "easy" or "average" to swallow compared with the other levels of barium-a finding with important relevance for compliance when translated to treatment (e.g., dietary recommendations). Moreover, the 3 mo follow-up of subjects randomly assigned to use an intervention revealed that, of those hospitalized for pneumonia, subjects drinking thick honey liquids (3,000 cP) were hospitalized an average of 2 wk longer than subjects drinking nectar liquids (median = 18 vs 4 d, respectively) [12]. The thick honey barium may be more challenging to safely clear from the airway because the force required to move material, in this case ejecting from the airway, increases with higher viscosity and yield stress [13].…”

Section: Introductionmentioning

confidence: 99%

“…Findings from the largest National Institutes of Health (NIH)-funded, multisite, randomized clinical trial for dysphagia provide the highest level of evidence available to demonstrate the effectiveness of thickened liquids to prevent (1) liquid aspiration in the fluoroscopy suite during the VFSS (short-term) [11] and (2) pneumonia during a 3 mo follow-up period (long-term) [12]. That trial enrolled 742 subjects who underwent a VFSS using thin (<15 cP), nectar thick (300 cP), and honey thick (3,000 cP) bariums.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of standardized bariums with varying rheological parameters on swallowing kinematics in males

Hind

Divyak²,

Zielinski³

et al. 2012

JRRD

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Abstract-This study measured dose-response of a range of commercially available liquid barium materials designed for use in videofluoroscopic oropharyngeal swallowing assessments, particularly as they relate to the necessity of adding a thickening agent for swallow safety. A group of 25 adult males representing various medical diagnoses consented to participate, with 16 qualifying to complete a videofluoroscopic swallowing assessment with liquid barium materials of three viscosities (nectar: 300 cP, thin honey: 1,500 cP, thick honey: 3,000 cP). Outcome measures included airway invasion (Penetration-Aspiration score), postswallow residue, and patient preference. Penetration-Aspiration and residue scores did not significantly differ between thin honey and thick honey bariums. Significantly more severe airway invasion was observed with nectar boluses than with two levels of honey boluses (p < 0.001). Significantly more residue was observed in the oral cavity (p < 0.002) and valleculae (p < 0.001) with thin and thick honey bariums than with nectar barium. Thin honey was rated as "easy" or "average" to drink by 67% of subjects, compared with 54% for thick honey. This study supports the use of thin honey barium over thick honey barium during videofluoroscopic swallowing assessments because the two honey bariums were comparable in terms of airway protection and postswallow residue in the oropharynx and the thin honey was preferred by patients.

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Section: Discussionmentioning

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of standardized bariums with varying rheological parameters on swallowing kinematics in males

Hind

Divyak²,

Zielinski³

et al. 2012

JRRD

Self Cite

View full text Add to dashboard Cite

show abstract

“…2008; Robbins et al. 2008). In addition, thickening liquids can affect the patient's hydration status if they dislike the thickening (Robbins et al.…”

Section: Discussionmentioning

confidence: 99%

Orosensory contributions to dysphagia: a link between perception of sweet and sour taste and pharyngeal delay time

Pauloski

Nasir

2016

Physiol Rep

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Pharyngeal delay is a significant swallowing disorder often resulting in aspiration. It is suspected that pharyngeal delay originates from sensory impairment, but a direct demonstration of a link between oral sensation and pharyngeal delay is lacking. In this study involving six patients with complaints of dysphagia, taste sensation of the oral tongue was measured and subsequently related to swallowing kinematics. It was found that a response bias for sour taste was significantly correlated with pharyngeal delay time on paste, highlighting oral sensory contributions to swallow motor dysfunctions. Investigating the precise nature of such a link between oral sensation and dysphagia would constitute a basis for understanding the disorder. The results of this study highlight oral sensory contributions to pharyngeal swallow events and provide impetus to examine this link in larger samples of dysphagic patients.

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“…Only articles on the effects of therapy for oropharyngeal dysphagia in Parkinson's disease were included. Studies describing heterogeneous subject populations that included patients with Parkinson's disease and patients with other neurologic diseases were excluded [6], except those studies that presented both pre-and posttreatment data per subgroup [7]. Patients receiving deep brain stimulation were excluded.…”

Section: Methodsmentioning

confidence: 99%

Effects of Therapy for Dysphagia in Parkinson’s Disease: Systematic Review

2008

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This systematic review explores the effects of dysphagia treatment for Parkinson's disease. The review includes rehabilitative, surgical, pharmacologic, and other treatments. Only oropharyngeal dysphagia is selected for this literature search, excluding dysphagia due to esophageal or gastric disorders. The effects of deep brain stimulation on dysphagia are not included. In general, the literature concerning dysphagia treatment in Parkinson's disease is rather limited. Most effect studies show diverse methodologic problems. Multiple case studies and trials are identified by searching biomedical literature databases PubMed and Embase, and by hand-searching reference lists. The conclusions of most studies cannot be compared with one another because of heterogeneous therapy methods and outcome measures. Further research based on randomized controlled trials to determine the effectiveness of different therapies for dysphagia in Parkinson's disease is required.

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Comparison of 2 Interventions for Liquid Aspiration on Pneumonia Incidence

Cited by 277 publications

References 30 publications

Comparison of standardized bariums with varying rheological parameters on swallowing kinematics in males

Comparison of standardized bariums with varying rheological parameters on swallowing kinematics in males

Orosensory contributions to dysphagia: a link between perception of sweet and sour taste and pharyngeal delay time

Effects of Therapy for Dysphagia in Parkinson’s Disease: Systematic Review

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