Speech Pathology Department, Royal Brisbane and Women's Hospital, Queensland Health, Herston, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Australia.
Am J Speech Lang Pathol. 2019 Aug 9;28(3):1248-1256. doi: 10.1044/2019_AJSLP-19-0045. Epub 2019 Jul 24.
Purpose Existing studies examining the effect of carbonated fluids on swallow physiology under videofluoroscopy (videofluoroscopic swallowing studies [VFSSs]) have significant variability across the fluids tested and limited consideration of the stability of the carbonation or fluid palatability. This study compared the effervescence behavior, carbonation intensity (sour, bite, bubble), palatability, and sip volumes of carbonated liquids as used in VFSSs and control samples. Method Forty-two healthy women (20 supertasters, 22 nontasters; 20-61 years old) took sips of 4 different liquids (water, carbonated water, barium sulfate with sodium bicarbonate granules, and barium sulfate with carbonated water) across 2 time conditions (on preparation and 5 min postpreparation). The 8 conditions were presented in 100-ml amounts, in randomized order. At presentation of each fluid, participants immediately rated effervescence via visual inspection. Then after sips of each fluid, participants rated perceived intensity of sour, "bubbles" and "bite," and palatability. Sip size was derived from residual volumes. Participant perceptions of fluids were also collected. Results The effervescence of barium sulfate with sodium bicarbonate granules, as used in the majority of published studies, was most impacted by time (p < .05), rated poorly for palatability, and had the largest impact on sip size (p < .05). Participant comments regarding the VFSS fluids were grouped in 4 themes: (a) adverse/other reactions, (b) awareness of sensory properties, (c) physiological reactions, and (d) swallow changes. Conclusions The significant differences between liquids regarding effervescence behavior, impact of preparation time, palatability, impact on naturalistic sipping, and patient perceptions warrant consideration when testing carbonated fluids during videofluoroscopy.
现有研究在透视荧光检查(VFSS)下观察碳酸饮料对吞咽生理的影响时,测试的液体具有很大的可变性,且对碳酸化的稳定性或液体口感的考虑有限。本研究比较了 VFSS 中使用的碳酸饮料和对照样品的冒泡行为、碳酸化强度(酸、咬、泡)、口感和吞咽量。
42 名健康女性(20 名超级味觉者,22 名非味觉者;20-61 岁)饮用 4 种不同的液体(水、碳酸水、含碳酸氢钠颗粒的硫酸钡、含碳酸水的硫酸钡),每种液体在 2 种时间条件下(准备时和准备后 5 分钟)各饮用一口。8 种条件以 100ml 为单位,随机呈现。每种液体呈现时,参与者立即通过视觉检查来评估冒泡情况。然后,在饮用每种液体后,参与者评估感知的酸味、“气泡”和“咬感”强度以及口感。根据残留量得出吞咽量。还收集了参与者对液体的看法。
钡硫酸与碳酸氢钠颗粒的混合物(大多数已发表研究中使用的物质)的冒泡情况受时间的影响最大(p<.05),口感评价较差,对吞咽量的影响最大(p<.05)。参与者对 VFSS 液体的评价分为 4 个主题:(a)不良反应/其他反应,(b)对感官特性的认识,(c)生理反应,以及(d)吞咽变化。
在冒泡行为、准备时间的影响、口感、对自然吞咽的影响以及患者认知方面,这些液体之间存在显著差异,在透视荧光检查中测试碳酸饮料时需要考虑这些差异。