Dysphagia dietary guidelines and the rheology of nutritional feeds and barium test feeds
Dysphagia dietary guidelines and the rheology of nutritional feeds and barium test feeds
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DOI：
10.1378/chest.08-0255
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发表时间：
2008-06-01
期刊：
影响因子：
9.6
通讯作者：
Rubin, Bruce
中科院分区：
文献类型：
--
作者：
Strowd, Lindsay;Kyzima, Julie;Rubin, Bruce
背景：吞咽困难可导致吸入口服饲料，从而引起肺炎。吞咽困难是通过评估吞咽能力，钡试验饲料（BTF）的不同粘度。吞咽困难饮食食品（DDF）根据国家吞咽困难饮食（NDD）指南的建议进行增稠。方法：TA 1000流变仪（TA Instruments;新城堡，DE）使用受控应力下的蠕变转变测量BTF和DDF的动态粘度。研究的稀DDF包括Plus Energy Drink（Boost; Novartis/Nestle; Fremont，MI）和Instant Breakfast（Carnation;威尔克斯-巴雷，PA）以及来自荷美尔（Hormel Health Labs;萨凡纳，GA）和诺华（Novartis/Nestle）的花蜜和蜂蜜稠DDF。研究的BTF是稀薄的、花蜜状的和蜂蜜状的Polibar钡悬浮液或Varibar（E-Z-EM，Inc.; Lake Success，NY）。我们测量了批次间DDF粘度的变化，有和没有振荡，并在环境温度下2小时后，在剪切速率选择，以匹配自然swallowing.Results：我们观察到割草：（1）DDF：蜂蜜厚DDF的粘度是符合NDD指南，但其他产品没有。所有产物在2小时内粘度变化最小。Boost稀液在振荡后粘度增加> 300%。(2)BTF：稀钡的粘度与NDD指南一致。花蜜和蜂蜜厚的Polibar BTF是触变性的，并且具有不可接受的高粘度。Varibar BTF没有触变性，但比NDD guidelines.Conclusions更粘稠：DDF和BTF的粘度之间的关系很差。BFT的粘度远大于相应命名的减肥食品和NDD指南。这可能使患者面临口腔误吸的重大风险。
Background: Dysphagia can lead to aspiration of oral feeds, thus causing pneumonia. Dysphagia is diagnosed by assessing the ability to swallow, barium test feeds (BTF) of different viscosities. Dysphagia diet foods (DDF) are thickened as recommended by the National Dysphagia Diet (NDD) guidelines. To our knowledge, there are no published data evaluating if the viscosity of BTF or commercial DDF meet NDD guidelines.Methods: A TA1000 rheometer (TA Instruments; New Castle, DE) measured dynamic viscosity of BTF and DDF using creep transformation under controlled stress. Thin DDF studied included Plus Energy Drink (Boost; Novartis/Nestle; Fremont, MI) and Instant Breakfast (Carnation; Wilkes-Barre, PA) and nectar- and honey-thick DDF from Hormel (Hormel Health Labs; Savannah, GA) and Novartis (Novartis/Nestle). The BTF studied were thin, nectar-, and honey-thick Polibar barium suspension or Varibar (E-Z-EM, Inc.; Lake Success, NY). We measured batch-to-batch variability in the viscosity of DDF, with and without shaking, and after 2 h at ambient temperature at a shear rate chosen to match natural swallowing.Results: We observed the Mowing: (1) DDF: the viscosity of honey-thick DDF was consistent with NDD guidelines, but other products were not. All products, had minimal change in viscosity over 2 h. Boost thin liquid had > 300% increase in viscosity after shaking. (2) BTF: thin barium had a viscosity consistent with NDD guidelines. The nectar- and honey-thick Polibar BTFs were thixotropic and had unacceptably high viscosity. Varibar BTFs were not thixotropic but were more viscous than the NDD guidelines.Conclusions: There was a poor relationship between the viscosity of DDF and BTF. The viscosity of BFTs is much greater than the correspondingly named diet foods and the NDD guidelines. This can place patients at significant risk for oral aspiration.