Rofes Laia, Arreola Viridiana, Clavé Pere
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain.
Nestle Nutr Inst Workshop Ser. 2012;72:33-42. doi: 10.1159/000339979. Epub 2012 Sep 24.
Oropharyngeal dysphagia (OD) is a major complaint among many patients with neurological diseases and in the elderly, but is often underdiagnosed. The volume-viscosity swallow test (V-VST) is a bedside method to screen patients for dysphagia.
The V-VST was designed to identify clinical signs of impaired efficacy (labial seal, oral and pharyngeal residue, and piecemeal deglutition) and impaired safety of swallow (voice changes, cough and decrease in oxygen saturation ≥3%). It starts with nectar viscosity and increasing bolus volume, then liquid and finally pudding viscosity in a progression of increasing difficulty to protect patients from aspiration.
The V-VST allows quick, safe and accurate screening for OD in hospitalized and independently living patients with multiple etiologies. The V-VST presents a sensitivity of 88.2% and a specificity of 64.7% to detect clinical signs of impaired safety of swallow (aspiration or penetration). The test takes 5-10 min to complete.
The V-VST is an excellent tool to screen patients for OD. It combines good psychometric properties, a detailed and easy protocol designed to protect safety of patients, and valid end points to evaluate safety and efficacy of swallowing and detect silent aspirations.
口咽吞咽困难（OD）是许多神经系统疾病患者和老年人的主要诉求，但常常诊断不足。容积-黏度吞咽测试（V-VST）是一种用于筛查吞咽困难患者的床旁检查方法。
V-VST旨在识别有效性受损的临床体征（唇部密封、口腔和咽部残留以及分次吞咽）和吞咽安全性受损的体征（声音改变、咳嗽以及血氧饱和度下降≥3%）。测试从饮用花蜜样黏度的液体开始，逐渐增加团块体积，然后是液体，最后是布丁样黏度的食物，难度逐渐增加，以防止患者误吸。
V-VST能够对多种病因的住院患者和独立生活患者进行快速、安全且准确的OD筛查。V-VST检测吞咽安全性受损（误吸或渗透）临床体征的灵敏度为88.2%，特异度为64.7%。该测试需要5-10分钟完成。
V-VST是筛查OD患者的优秀工具。它具有良好的心理测量特性，有一个详细且易于操作的方案以保障患者安全，还有有效的终点指标来评估吞咽的安全性和有效性并检测隐匿性误吸。
