title: Videoradiographic analysis of how carbonated thin liquids and thickened liquids affect the physiology of swallowing in subjects with aspiration on thin liquids.
abstract: OBJECTIVE
  To analyze how carbonated thin liquids affected the physiology of swallowing in dysphagic patients.
  
  
  METHODS
  40 patients were analyzed; 36 were neurologically impaired. During a therapeutic videoradiographic swallowing examination the patients had to swallow liquids with the following consistencies three times: thin, thickened and carbonated. The liquids were given in doses of 3 x 5 ml. The swallows were analyzed regarding penetration/aspiration, pharyngeal transit time and pharyngeal retention.
  
  
  RESULTS
  Significant difference was found regarding penetration/aspiration when comparisons were made between thin liquid and carbonated thin liquid (p<0.0001). Carbonated liquid reduced the penetration to the airways. The comparison between thin liquid and thickened liquid (p<0.0001) showed significant less penetration with thickened liquids. Pharyngeal transit time was reduced both when comparing thin liquid with thin carbonated liquid (p<0.0001) and thickened liquid (p<0.0001). Pharyngeal retention was significantly reduced (p<0.0001) with carbonated thin liquid compared to thickened liquid. The comparison of thin liquids and carbonated thin liquids showed p=0.0013, thin and thickened liquids p=0.0097.
  
  
  CONCLUSIONS
  Carbonated liquids reduced penetration/aspiration into the airways, reduced pharyngeal retention and pharyngeal transit time became shorter. Therefore, carbonated liquids are a valuable treatment option for patients with penetration/aspiration. Thickened liquids may still be an option for patients who cannot tolerate carbonated liquids and liquids with this consistency are safer than thin liquids.
authors.affiliation: Department of Diagnostic Radiology, Malmö University Hospital, Lund University, Malmö, Sweden. Margareta.Bulow@rontgen.mas.lu.se
authors.forename: M
authors.initials: M
authors.lastname: Bülow
authors.forename: R
authors.initials: R
authors.lastname: Olsson
authors.forename: O
authors.initials: O
authors.lastname: Ekberg
mesh_terms: D000368:Aged; D002245:Carbon Dioxide; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D010614:Pharynx / Q000503:physiopathology; D011015:Pneumonia, Aspiration / Q000503:physiopathology*; D011859:Radiography; D012996:Solutions; D014741:Video Recording
chemical_list: D012996:Solutions; D002245:Carbon Dioxide