Dataset Information

Effect of a gum-based thickener on the safety of swallowing in patients with poststroke oropharyngeal dysphagia.

ABSTRACT:

Background

Increasing viscosity with thickening agents is a valid therapeutic strategy for oropharyngeal dysphagia (OD). To assess the therapeutic effect of a xanthan gum-based thickener (Nutilis Clear^® ) at six viscosities compared with thin liquid in poststroke OD (PSOD) patients.

Methods

A total of 120 patients with PSOD were studied in this controlled, multiple-dose, fixed-order, and single-blind study using videofluoroscopy (VFSS). A series of boluses of 10 mL thin liquid and 2000, 1400, 800, 450, 250, and 150 mPa s viscosities were given in duplicate, interrupted in case of aspiration. We assessed the safety and efficacy of swallow and the kinematics of the swallow response.

Key results

A total of 41.2% patients had safe swallow at thin liquid which significantly increased for all viscosities from 71.9% at 150 mPa s to 95.6% at 1400 mPa s (P < .001). PAS score (3.7 ± 2.3) at thin liquid was also reduced by increasing bolus viscosity (P < .001). The prevalence of patients with aspiration at thin liquid was 17.5% and decreased at all viscosities (P < .01), except at 150 mPa s. Increasing viscosity shortened time to laryngeal vestibule closure (LVC) at all viscosities (P < .01) and reduced bolus velocity at ?450 mPa s (P < .05). The prevalence of patients with pharyngeal residue at each viscosity 37.7%-44.7% was similar to that at thin liquid (41.2%).

Conclusions and inferences

The prevalence of unsafe swallow with thin liquids is very high in PSOD. Increasing shear bolus viscosity with this xanthan gum-based thickener significantly increased the safety of swallow in patients with PSOD in a viscosity-dependent manner without increasing the prevalence of pharyngeal residue.

SUBMITTER: Bolivar-Prados M

PROVIDER: S-EPMC6852432 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Publications

Effect of a gum-based thickener on the safety of swallowing in patients with poststroke oropharyngeal dysphagia.

Bolivar-Prados Mireia M Rofes Laia L Arreola Viridiana V Guida Sonia S Nascimento Weslania V WV Martin Alberto A Vilardell Natàlia N Ortega Fernández Omar O Ripken Dina D Lansink Mirian M Clavé Pere P

Neurogastroenterology and motility 20190811 11

<h4>Background</h4>Increasing viscosity with thickening agents is a valid therapeutic strategy for oropharyngeal dysphagia (OD). To assess the therapeutic effect of a xanthan gum-based thickener (Nutilis Clear<sup>®</sup> ) at six viscosities compared with thin liquid in poststroke OD (PSOD) patients.<h4>Methods</h4>A total of 120 patients with PSOD were studied in this controlled, multiple-dose, fixed-order, and single-blind study using videofluoroscopy (VFSS). A series of boluses of 10 mL thin ...[more]

PMID: 31402571

Similar Datasets

Project description:BackgroundOropharyngeal dysphagia (OD), a common symptom in the elderly, uses commercial thickener (CT) as part of its treatment. This is often accompanied of dislike and poor compliance.AimDescribe adherence to CT and possible differences according to dwelling location in an area of influence of approximately 400.0000 inhabitants.MethodsCohort prospective observational study. Randomized patients from Nutrition and Dietetic (NDU)-database (4 calls-interviews/year).VariablesAge, diagnostic, gender, dwelling/location: Home (H) / Nursing Home (NH), viscosity (nectar, honey, pudding), days with CT. Adherence measured with a questionnaire, considering implementation of treatment by combining CT use and consumption data, categorised in three groups good, moderate and poor. Change in patterns (improvement, maintenance, worsening) and non-adherence reasons.ResultsOne hundred sixty-eight patients recruited with indicated viscosity: Nectar 39.7%, honey 29.3% and pudding 30.8%. Average age of 82.6 ± 11.1 years; 57.8% women (46.4% at H vs. 67% at NH, p < 0.01). Dwelling/location: 80 (47.6%) live at H and 88 (52.4%) at NH. Days with CT prior study were 509 ± 475.28. Implementation found in first call: good in 50%, moderate in 20.2% and poor in 29.8%. At first call, adherence parameters were more favourable in NH compared to H. However these parameters were reversed during the study period as there was an improvement at H vs. NH. Also in terms of change in patterns a significant improvement of implementation was found in patients living at H, 31.1% vs. those living at NH, 15.7%, p < 0.05. CT persistence throughout study was 89.7%.ConclusionsLow adherence to CT found in our community. Telephone follow-up resulted in improved adherence, especially in the H population. Our data provides valuable insights into the variability and changes in CT adherence among patients with OD. Adherence is complex and subject to many factors and dwelling/location is one of them. This study reveals the need to approach CT treatment for OD differently in NH.

Dataset Information

Effect of a gum-based thickener on the safety of swallowing in patients with poststroke oropharyngeal dysphagia.

Background

Methods

Key results

Conclusions and inferences

Publications

Effect of a gum-based thickener on the safety of swallowing in patients with poststroke oropharyngeal dysphagia.

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