Lundine Jennifer P, Bates D Gregory, Yin Han
Department of Speech Pathology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA,
Pediatr Radiol. 2015 Aug;45(9):1323-32. doi: 10.1007/s00247-015-3314-z. Epub 2015 Mar 11.
Aspiration of liquids is a serious complication of neurological impairments such as traumatic brain injury or stroke. Carbonated liquids have been examined as a possible alternative to thickened liquids to help reduce aspiration in cases of dysphagia in adults, but no published literature to the best of our knowledge has evaluated this technique in children. If carbonated liquids result in safer swallowing in children, they could provide a preferred alternative to thickened liquids.
This pilot study examined whether carbonated thin liquids (CARB) improved swallowing compared to non-carbonated thin liquids (NOCARB) for children with neurogenic dysphagia.
Twenty-four children admitted to a level I trauma center for acute neurological injury/disease were evaluated via videofluoroscopic swallow studies. Four descriptive outcome measures were contrasted.
CARB significantly decreased pooling (P = 0.0006), laryngeal penetration/aspiration (P = 0.0044) and Penetration-Aspiration Scale scores (P = 0.0127) when compared to NOCARB. On average, CARB improved scores on the Penetration-Aspiration Scale by 3.7 points for participants who aspirated NOCARB. There was no significant difference in pharyngeal residue noted between CARB and NOCARB (P = 0.0625).
These findings support the hypothesis that carbonated thin liquids may provide an alternative to thickened liquids for children with neurogenic dysphagia. Implications for future research and clinical practice are discussed.
液体误吸是创伤性脑损伤或中风等神经功能障碍的严重并发症。碳酸饮料已被研究作为增稠液体的一种可能替代物,以帮助减少成人吞咽困难患者的误吸,但据我们所知,尚无已发表的文献对儿童使用该技术进行评估。如果碳酸饮料能使儿童吞咽更安全,那么它们可能成为增稠液体的首选替代品。
这项初步研究探讨了对于患有神经源性吞咽困难的儿童,与非碳酸稀液体(NOCARB)相比,碳酸稀液体(CARB)是否能改善吞咽功能。
对入住一级创伤中心的24名因急性神经损伤/疾病入院的儿童进行了视频荧光吞咽造影研究评估。对比了四项描述性结果指标。
与NOCARB相比,CARB显著减少了液体潴留(P = 0.0006)、喉穿透/误吸(P = 0.0044)和穿透-误吸量表评分(P = 0.0127)。平均而言,对于误吸NOCARB的参与者,CARB使穿透-误吸量表评分提高了3.7分。CARB和NOCARB之间在咽部残留方面没有显著差异(P = 0.0625)。
这些发现支持了以下假设,即对于患有神经源性吞咽困难的儿童,碳酸稀液体可能是增稠液体的一种替代品。讨论了对未来研究和临床实践的意义。