Viscosidade e qualidade da imagem do líquido espessado para videodeofluoroscopia de deglutição com acréscimo do contraste de bário

Viscosity study of maternal and formula milks according to the assessment proposed by the International Dysphagia Diet Standardisation Initiative Model: a comparison with Rheological Assessment

PURPOSE

The present study aimed to investigate the behavior and the viscosity classification of liquids recommended for infants, up to six months, in Brazil, and their formulations used in Videofluoroscopy Swallowing Studies.

METHODS

Breast milk from different gestational and breastfeeding time, two regular infant formulas, and one anti-reflux formula were evaluated in five different formulations: pure, mixed with liquid barium sulfate, in two proportions (20 and 33%), thickened with a specific thickener for neonates and thickened and mixed with 20% liquid barium sulfate, using the International Dysphagia Diet Standardisation Initiative model. The results were compared with data obtained from a previous rheological study.

RESULTS

The breast milk samples and the infant formulas, in pure presentation, exhibited similar behavior except for the anti-reflux formula. The thickened samples with the addition of barium and the pure liquid barium sulfate exhibited the highest viscosity among the formulations. The increase in viscosity with the addition of barium occurred for all samples and for the thickened formulations, but not in linear behavior. The results showed minor differences of IDDSI classification compared to the findings obtained in the rheological study.

CONCLUSION

The present study revealed the variability of liquid viscosity across different formulations, supporting the idea of the importance of this knowledge in videofluoroscopic assessment. It has also highlighted the risk associated with using a subjective method in preparing the stimuli offered, allowing for greater reliability in diagnosing swallowing dynamics in neonates and infants. This approach may help prevent inaccurate diagnoses and harmful interventions.

Consistencies and terminologies - the use of the International Dysphagia Diet Standardization Initiative

Introduction

Introduction: this study aimed to verify the ability of speech therapists to identify, sort and name the different consistencies used in neurogenic oropharyngeal dysphagia (NOD) management, and to compare the results with the terms proposed by the International Dysphagia Diet Standardization Initiative (IDDSI). Methods: this research was approved by the ethics committee. Sixty speech therapists who work with NOD patients sorted 5 commercial foods from thinnest to thickest to match IDDSI levels 0 to 4, and then used a term to designate each consistency. Results: most subjects (76.66%) sorted the foods properly. Terminologies were divergent at all levels. For level 0, practitioners assigned 3 different terms. For level 1, 24 different terms were reported; for level 2 there were 25 terms, 23 terms for level 3, and 18 terms for level 4. Level 0 (IDDSI - thin) was designated by most participants as liquid; level 1 (IDDSI - slightly thick) was referred to as semi-thickened liquid; level 2 (IDDSI - mildly thick) as thickened liquid; level 3 (IDDSI - moderately thick) as honey; and level 4 (IDDSI - extremely thick) as pasty by most subjects. A reduced number of participants used terms in accordance with IDDSI. Level 0 was appropriately named by 5 subjects (8.33%); levels 1, 2 and 4 by 2 practitioners each (3.33%); and level 3 by 1 professional (1.66%). None of the subjects named all 5 IDDSI levels correctly. Conclusion: most practitioners progressed consistencies properly. There was a diversity of terminologies used for the same consistency at all levels, with no standardization.