Faculty Collaboration Database

Prevention of barium aspiration during videofluoroscopic swallowing studies: value of change in posture. AJR Am J Roentgenol 1993 May;160(5):1005-9

Date

05/01/1993

Pubmed ID

8470567

DOI

10.2214/ajr.160.5.8470567

Scopus ID

2-s2.0-0027276793 (requires institutional sign-in at Scopus site)   166 Citations

Abstract

OBJECTIVE: We investigated the frequency with which changes in the position of a patient's head or body eliminated aspiration of liquid barium during videofluoroscopic swallowing studies in patients with oropharyngeal dysphagia. We also studied factors that influenced the effect of posture on aspiration.

SUBJECTS AND METHODS: The study group comprised 165 patients consecutively referred for videofluoroscopic examination of the oropharyngeal stages of swallowing in whom aspiration of barium occurred while swallowing 1, 3, 5, or 10 ml of thin liquid barium or drinking barium from a cup. When aspiration occurred, the patient changed to one of five postures (chin down, chin up, head rotated, head tilted, and lying down), selected on the basis of the specific swallowing abnormality causing the aspiration.

RESULTS: Changes in head or body position eliminated aspiration of at least one bolus of barium in 127 (77%) of the 165 patients, and of all four boluses plus drinking barium from a cup in 41 patients (25%). Postural changes were less beneficial in preventing aspiration in patients with substantial language or cognitive defects or restricted head movement.

CONCLUSIONS: Postural techniques can eliminate aspiration of barium of at least small volumes in most patients. Expansion of the oropharyngeal swallowing study to include the effect of various postures can be done with minimal risk of increased aspiration.

Author List

Rasley A, Logemann JA, Kahrilas PJ, Rademaker AW, Pauloski BR, Dodds WJ

Author

Barbara R. Pauloski PhD, CCC-SLP Associate Professor in the Communication Sciences & Disorders department at University of Wisconsin - Milwaukee

MESH terms used to index this publication - Major topics in bold

Barium Sulfate
Deglutition
Deglutition Disorders
Fluoroscopy
Humans
Middle Aged
Oropharynx
Pneumonia, Aspiration
Posture
Risk Factors
Videotape Recording