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22-08-2011 | Speech-language pathology | Article

Fizzy drinks may help swallowing after stroke


Free abstract

MedWire News: Individuals with neurogenic dysphagia are less likely to aspirate small amounts of carbonated thin liquids (CTLs) than non-carbonated thin liquids (NCTLs), findings from a study indicate.

However, the risk for aspiration is unaffected by carbonation when such patients drink volumes of thin liquid greater than 25 ml, the authors explain.

Katerina Sdravou (Trinity College Dublin, Ireland) and colleagues recruited 17 patients, aged 22-80 years, with neurogenic dysphagia arising from stroke (n=13) or traumatic brain injury (n=4). At the time of assessment, eight patients were being fed via a nasogastric or percutaneous endoscopic gastrostomy tube, and the remaining nine patients were feeding by mouth.

The pharyngeal function of all patients was assessed by videofluoroscopy and quantified by measurements of oral transit time (OTT), pharyngeal transit time (PTT), stage transition duration (STD), initiation of the pharyngeal swallow (IPS), and pharyngeal retention (PR).

When 5 and 10 ml of CTL and NCTL was given to each patient using a spoon and cup, respectively, aspiration was less frequent on drinking CTLs compared with NCTLs. Indeed, aspiration risk, as reflected by penetration-aspiration scale score, was significantly lower for 5 and 10 ml CTL than NCTL swallows.

However, no difference in aspiration risk was evident for 25 ml swallows of CTLs and NCTLs. Indeed, no significant difference was seen between the effect of CTLs and NCTLs of any volume when any measure of pharyngeal function was used.

Palatability of the CTL used (a barium liquid) was assessed using a modified version of the Quartermaster Hedonic Scale. In all, 58.8% (n=10) of the patients said they liked or extremely liked the CTL and 17.7% (n=3) expressed a dislike of the CTL.

To date, thickening of liquids remains the strategy of choice for minimizing aspiration risk in patients with neurogenic dysphagia, say Sdravou and team in the journal Dysphagia.

However, they add that this strategy has been found to increase the risk for pneumonia and dehydration in such patients.

"As a compensatory strategy, altering the characteristics of the food bolus, focusing on sensory stimulation to modulate the oropharyngeal swallow process, shows some promise," say the authors.

They therefore recommend further research to assess the impact of CTL on patient hydration and quality of life in order to identify its true potential in neurogenic dysphagia patients.

By Lauretta Ihonor

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