Abstract:
BACKGROUND:The modifications of fluid viscosity and/or volume are common strategies in dysphagia management, with increased viscosity or reduced volume intended to reduce aspiration. Little attention has been given to whether cough response to aspiration varies across different viscosities and volumes. AIMS:This prospective observational study investigated aspiration prevalence and cough response to aspiration in thin and thick fluids of two different volumes in patients referred for flexible endoscopic evaluation of swallowing (FEES) in an acute hospital setting. METHODS & PROCEDURES:Consecutive inpatients (N = 180) referred for FEES were recruited: stroke 51 (28%); other neurological condition (traumatic brain injury, progressive neurological) 33 (18%); cardiovascular critical care 51 (28%); respiratory illness/condition 23 (13%); spinal injury 9 (5%); and other 13 (7%). A standardized protocol was completed on 268 FEES (180 first FEES, 88 repeat FEES). Penetration-aspiration scale (PAS) scores were obtained for thin and mildly thick fluids at two volumes: 5 ml teaspoon and 50 ml continuous drinking. OUTCOMES & RESULTS:The incidence of aspiration (PAS > 5) was 32% for thin fluids and 18% for thick fluids. There was a significant association between cough response to aspiration and viscosity (p < .001) and volume (p < .001). There was a higher prevalence of silent aspiration in thick fluids than thin fluids. Some patients demonstrated variable cough responsiveness to aspiration across different viscosities and volumes. With 5 ml volumes, 20 patients coughed when they aspirated thin fluids but silently aspirated thick fluids. In comparison, discrepancies in the 50 ml volume were fewer, with three patients coughing when they aspirated thin fluids but silently aspirating thick fluids. CONCLUSIONS & IMPLICATIONS:Cough response to aspiration differs across bolus volumes and viscosities. The finding of inconsistent cough response to aspiration in some patients strongly encourages the use of instrumental assessment to guide decisions regarding diet modifications.
journal_name
Int J Lang Commun Disordauthors
Miles A,McFarlane M,Scott S,Hunting Adoi
10.1111/1460-6984.12401subject
Has Abstractpub_date
2018-09-01 00:00:00pages
909-918issue
5eissn
1368-2822issn
1460-6984journal_volume
53pub_type
杂志文章abstract:BACKGROUND:People with profound intellectual and multiple disabilities (PMLD) have communication impairments as one defining characteristic. AIMS:To explore speech and language therapists' (SLTs) decision making in communication interventions for people with PMLD, in terms of the intervention approaches used, the fact...
journal_title:International journal of language & communication disorders
pub_type: 杂志文章
doi:10.1111/1460-6984.12098
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:In general, children with specific language impairment (SLI) tend to fall behind their typically developing (TD) peers in educational attainment. Less is known about how children with SLI fare in particular areas of the curriculum and what predicts their levels of performance. AIMS:To compare the distributi...
journal_title:International journal of language & communication disorders
pub_type: 杂志文章
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abstract:BACKGROUND:Children with dyslexia and/or developmental language disorder (hereafter children with DDLD) have been reported to retrieve fewer words than their typically developing (TD) peers in semantic fluency tasks. It is not known whether this retrieval difficulty can be attributed to the semantic structure of their ...
journal_title:International journal of language & communication disorders
pub_type: 杂志文章
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journal_title:International journal of language & communication disorders
pub_type: 杂志文章
doi:10.1111/1460-6984.12417
更新日期:2018-11-01 00:00:00
abstract::Clinical teaching of students is a requirement of the majority of practicing therapists in the UK and yet there is little guidance as to the nature of the placement which needs to be offered. As models of service delivery change, placements must change to prepare the student for working life whilst also meeting the ne...
journal_title:International journal of language & communication disorders
pub_type: 杂志文章
doi:10.3109/13682829809179401
更新日期:1998-01-01 00:00:00
abstract::Care aims are a means of defining the purpose of intervention of health care. The Malcomess care aims model uses these labels to guide the planning, delivery and outcome measurement of care. Within speech and language therapy (SLT) this involves the use of one of seven labels which clarify and make explicit the purpos...
journal_title:International journal of language & communication disorders
pub_type: 杂志文章
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更新日期:2001-01-01 00:00:00
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journal_title:International journal of language & communication disorders
pub_type: 杂志文章
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更新日期:1999-01-01 00:00:00
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journal_title:International journal of language & communication disorders
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更新日期:2017-07-01 00:00:00
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pub_type: 杂志文章
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journal_title:International journal of language & communication disorders
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journal_title:International journal of language & communication disorders
pub_type: 杂志文章,评审
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更新日期:2008-03-01 00:00:00
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journal_title:International journal of language & communication disorders
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journal_title:International journal of language & communication disorders
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更新日期:2001-01-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2012-01-01 00:00:00
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journal_title:International journal of language & communication disorders
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更新日期:2001-01-01 00:00:00
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journal_title:International journal of language & communication disorders
pub_type: 杂志文章
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journal_title:International journal of language & communication disorders
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更新日期:1998-01-01 00:00:00
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journal_title:International journal of language & communication disorders
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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更新日期:2011-01-01 00:00:00