Cichero J A, Jackson O, Halley P J, Murdoch B E
Department of Speech Pathology & Audiology, University of Queensland, Brisbane, Australia.
J Speech Lang Hear Res. 2000 Apr;43(2):537-47. doi: 10.1044/jslhr.4302.537.
This investigation examined the rheological (viscosity and yield stress) and material property (density) characteristics of the thickened meal-time and videofluorscopy fluids provided by 10 major metropolitan hospitals. Differences in the thickness of thickened fluids were considered as a source of variability and potential hazard for inter-hospital transfers of dysphagic patients. The results indicated considerable differences in the viscosity, density, and yield stress of both meal-time and videofluoroscopy fluids. In theory, the results suggest that dysphagic patients transferred between hospitals could be placed on inappropriate levels of fluid thickness because of inherent differences in the rheology and material property characteristics of the fluids provided by different hospitals. Slowed improvement or medical complications are potential worst-case scenarios for dysphagic patients if the difference between the thick fluids offered by 2 hospitals are extreme. The investigation outlines the most appropriate way to assess the rheological and material property characteristics of thickened fluids. In addition, it suggests a plan of quality improvement to reduce the variability of the thickness of fluids offered at different hospitals.
本研究调查了10家主要大城市医院提供的增稠餐时和视频荧光吞咽造影检查用液体的流变学特性(粘度和屈服应力)及材料特性(密度)。增稠液体厚度的差异被视为吞咽困难患者在医院间转运时变异性和潜在风险的一个来源。结果表明,餐时和视频荧光吞咽造影检查用液体的粘度、密度和屈服应力存在显著差异。从理论上讲,这些结果表明,由于不同医院提供的液体在流变学和材料特性上存在固有差异,在医院间转运的吞咽困难患者可能会被给予不适当的液体厚度水平。如果两家医院提供的浓稠液体差异极大,吞咽困难患者病情改善缓慢或出现医疗并发症可能是最糟糕的情况。该研究概述了评估增稠液体流变学和材料特性的最合适方法。此外,它还提出了一项质量改进计划,以减少不同医院提供的液体厚度的变异性。