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Shear-Viscosity-Dependent Effect of a Gum-Based Thickening Product on the Safety of Swallowing in Older Patients with Severe Oropharyngeal Dysphagia

Fluid thickening is a valid therapeutic strategy for patients with oropharyngeal dysphagia (OD). The main aim of this study was to determine the therapeutic effect of the xanthan-gum-based thickener Tsururinko Quickly (TQ, Morinaga Milk Co., Tokyo, Japan) in older patients with severe OD. A total of...

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Autores principales: Bolivar-Prados, Mireia, Hayakawa, Yuki, Tomsen, Noemi, Arreola, Viridiana, Nascimento, Weslania, Riera, Stephanie, Kawakami, Satomi, Miyaji, Kazuhiro, Takeda, Yasuhiro, Kayashita, Jun, Clavé, Pere
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10384341/
https://www.ncbi.nlm.nih.gov/pubmed/37513697
http://dx.doi.org/10.3390/nu15143279
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author Bolivar-Prados, Mireia
Hayakawa, Yuki
Tomsen, Noemi
Arreola, Viridiana
Nascimento, Weslania
Riera, Stephanie
Kawakami, Satomi
Miyaji, Kazuhiro
Takeda, Yasuhiro
Kayashita, Jun
Clavé, Pere
author_facet Bolivar-Prados, Mireia
Hayakawa, Yuki
Tomsen, Noemi
Arreola, Viridiana
Nascimento, Weslania
Riera, Stephanie
Kawakami, Satomi
Miyaji, Kazuhiro
Takeda, Yasuhiro
Kayashita, Jun
Clavé, Pere
author_sort Bolivar-Prados, Mireia
collection PubMed
description Fluid thickening is a valid therapeutic strategy for patients with oropharyngeal dysphagia (OD). The main aim of this study was to determine the therapeutic effect of the xanthan-gum-based thickener Tsururinko Quickly (TQ, Morinaga Milk Co., Tokyo, Japan) in older patients with severe OD. A total of 85 patients (83.32 ± 6.75 y) with OD and a penetration–aspiration score (PAS) of n ≥ 3 were studied by videofluoroscopy while swallowing duplicate 10 mL boluses at <50 mPa·s, 100, 200, 400, 800, and 1600 mPa·s, to assess the safety and efficacy of swallowing and the biomechanics of a swallowing response at each viscosity level. At <50 mPa·s, only 16.25% patients swallowed safely, 45% had penetrations (PAS 3–5), and 38.75% had aspirations (PAS 6–8). Fluid thickening with TQ greatly increased the prevalence of patients with safe swallowing from 62.90% at 100 mPa·s to 95.24% at 1600 mPa·s in a shear-viscosity-dependent manner. The penetrations and aspirations were significantly reduced to 3.60% and 1.19%, respectively, at 1600 mPa·s. The threshold viscosity was 100 mPa·s and the increasing viscosity above 800 mPa·s did not further improve the therapeutic effect significantly. Increasing the shear viscosity significantly reduced the time to laryngeal vestibule closure (−16.70%), increased the time to upper oesophageal sphincter opening (+26.88%), and reduced the pharyngeal bolus velocity (−31.62%) without affecting the pharyngeal residue. TQ has a strong shear-viscosity-dependent effect on the safety of swallowing in older patients with severe OD without increasing the pharyngeal residue. The therapeutic range for TQ is 100–800 mPa·s, with 200 and 800 mPa·s being the optimal doses to cover the needs of older patients with OD.
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spelling pubmed-103843412023-07-30 Shear-Viscosity-Dependent Effect of a Gum-Based Thickening Product on the Safety of Swallowing in Older Patients with Severe Oropharyngeal Dysphagia Bolivar-Prados, Mireia Hayakawa, Yuki Tomsen, Noemi Arreola, Viridiana Nascimento, Weslania Riera, Stephanie Kawakami, Satomi Miyaji, Kazuhiro Takeda, Yasuhiro Kayashita, Jun Clavé, Pere Nutrients Article Fluid thickening is a valid therapeutic strategy for patients with oropharyngeal dysphagia (OD). The main aim of this study was to determine the therapeutic effect of the xanthan-gum-based thickener Tsururinko Quickly (TQ, Morinaga Milk Co., Tokyo, Japan) in older patients with severe OD. A total of 85 patients (83.32 ± 6.75 y) with OD and a penetration–aspiration score (PAS) of n ≥ 3 were studied by videofluoroscopy while swallowing duplicate 10 mL boluses at <50 mPa·s, 100, 200, 400, 800, and 1600 mPa·s, to assess the safety and efficacy of swallowing and the biomechanics of a swallowing response at each viscosity level. At <50 mPa·s, only 16.25% patients swallowed safely, 45% had penetrations (PAS 3–5), and 38.75% had aspirations (PAS 6–8). Fluid thickening with TQ greatly increased the prevalence of patients with safe swallowing from 62.90% at 100 mPa·s to 95.24% at 1600 mPa·s in a shear-viscosity-dependent manner. The penetrations and aspirations were significantly reduced to 3.60% and 1.19%, respectively, at 1600 mPa·s. The threshold viscosity was 100 mPa·s and the increasing viscosity above 800 mPa·s did not further improve the therapeutic effect significantly. Increasing the shear viscosity significantly reduced the time to laryngeal vestibule closure (−16.70%), increased the time to upper oesophageal sphincter opening (+26.88%), and reduced the pharyngeal bolus velocity (−31.62%) without affecting the pharyngeal residue. TQ has a strong shear-viscosity-dependent effect on the safety of swallowing in older patients with severe OD without increasing the pharyngeal residue. The therapeutic range for TQ is 100–800 mPa·s, with 200 and 800 mPa·s being the optimal doses to cover the needs of older patients with OD. MDPI 2023-07-24 /pmc/articles/PMC10384341/ /pubmed/37513697 http://dx.doi.org/10.3390/nu15143279 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bolivar-Prados, Mireia
Hayakawa, Yuki
Tomsen, Noemi
Arreola, Viridiana
Nascimento, Weslania
Riera, Stephanie
Kawakami, Satomi
Miyaji, Kazuhiro
Takeda, Yasuhiro
Kayashita, Jun
Clavé, Pere
Shear-Viscosity-Dependent Effect of a Gum-Based Thickening Product on the Safety of Swallowing in Older Patients with Severe Oropharyngeal Dysphagia
title Shear-Viscosity-Dependent Effect of a Gum-Based Thickening Product on the Safety of Swallowing in Older Patients with Severe Oropharyngeal Dysphagia
title_full Shear-Viscosity-Dependent Effect of a Gum-Based Thickening Product on the Safety of Swallowing in Older Patients with Severe Oropharyngeal Dysphagia
title_fullStr Shear-Viscosity-Dependent Effect of a Gum-Based Thickening Product on the Safety of Swallowing in Older Patients with Severe Oropharyngeal Dysphagia
title_full_unstemmed Shear-Viscosity-Dependent Effect of a Gum-Based Thickening Product on the Safety of Swallowing in Older Patients with Severe Oropharyngeal Dysphagia
title_short Shear-Viscosity-Dependent Effect of a Gum-Based Thickening Product on the Safety of Swallowing in Older Patients with Severe Oropharyngeal Dysphagia
title_sort shear-viscosity-dependent effect of a gum-based thickening product on the safety of swallowing in older patients with severe oropharyngeal dysphagia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10384341/
https://www.ncbi.nlm.nih.gov/pubmed/37513697
http://dx.doi.org/10.3390/nu15143279
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