Clin Nutr Res.  2019 Oct;8(4):265-271. 10.7762/cnr.2019.8.4.265.

Standard Recipes for the Preparation of Thickened Barium Liquids Used in the Diagnosis of Dysphagia

• Park J
• Yoo W
• Yoo B

• KMID: 2461094
• DOI: http://doi.org/10.7762/cnr.2019.8.4.265

Abstract

Barium sulfate is commonly used to prepare contrast media for videofluorograpy. The flow characteristics of thickened liquids formulated for oropharyngeal imaging are known to be greatly affected by the addition of barium. In this study, thickened barium liquids were prepared by mixing a commercial xanthan gum (XG)-based thickener (Visco-up®) at different concentrations (0.1%-3.0%) with barium powder (Baritop HD®), and differences in the viscosity between thickened non-barium and thickened barium liquids were investigated. In addition, the thickness levels of thickened barium liquids, which are based on the National Dysphagia Diet (NDD) and International Dysphagia Diet Standardization Initiative (IDDSI) guidelines, were classified by measuring the viscosity (NDD) and gravity flow through a syringe (IDDSI) with 0.1%-3.0% thickener concentrations. The apparent viscosity (η(a),â‚…â‚€) values of thickened barium liquids were much higher than those of thickened non-barium liquids, indicating that the addition of barium to the XG-based thickener resulted in further thickening. Standard recipes for preparing thickened barium liquids with desirable thickness levels were also established, showing the different thickener concentrations corresponding to the different NDD and IDDSI levels.

Keyword

Barium; Viscosity; Dysphasia

MeSH Terms

Aphasia
Barium Sulfate
Barium*
Contrast Media
Deglutition Disorders*
Diagnosis*
Diet
Gingiva
Gravitation
Syringes
Viscosity
Barium
Barium Sulfate
Contrast Media

Reference

1. Stuart S, Motz JM. Viscosity in infant dysphagia management: comparison of viscosity of thickened liquids used in assessment and thickened liquids used in treatment. Dysphagia. 2009; 24:412–422.

2. Popa Nita S, Murith M, Chisholm H, Engmann J. Matching the rheological properties of videofluoroscopic contrast agents and thickened liquid prescriptions. Dysphagia. 2013; 28:245–252.

3. Seo CW, Yoo B. Steady and dynamic shear rheological properties of gum-based food thickeners used for diet modification of patients with dysphagia: effect of concentration. Dysphagia. 2013; 28:205–211.

4. Cho HM, Yoo B. Rheological characteristics of cold thickened beverages containing xanthan gum-based food thickeners used for dysphagia diets. J Acad Nutr Diet. 2015; 115:106–111.

5. Adeleye B, Rachal C. Comparison of the rheological properties of ready-to-serve and powdered instant food-thickened beverages at different temperatures for dysphagic patients. J Am Diet Assoc. 2007; 107:1176–1182.

6. Kim SG, Yoo W, Yoo B. Effect of thickener type on the rheological properties of hot thickened soups suitable for elderly people with swallowing difficulty. Prev Nutr Food Sci. 2014; 19:358–362.

7. Kim CY, Yoo B. Rheological characterization of thickened protein-based beverages under different food thickeners and setting times. J Texture Stud. 2018; 49:293–299.

8. Cichero JA, Lam P, Steele CM, Hanson B, Chen J, Dantas RO, Duivestein J, Kayashita J, Lecko C, Murray J, Pillay M, Riquelme L, Stanschus S. Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: The IDDSI framework. Dysphagia. 2017; 32:293–314.

9. Jo W, Bak JH, Yoo B. Rheological characterizations of concentrated binary gum mixtures with xanthan gum and galactomannans. Int J Biol Macromol. 2018; 114:263–269.

10. Kim YH, Jeong GY, Yoo B. Comparative study of IDDSI flow test and line-spread test of thickened water prepared with different dysphagia thickeners. J Texture Stud. 2018; 49:653–658.

11. Hanson B. A review of diet standardization and bolus rheology in the management of dysphagia. Curr Opin Otolaryngol Head Neck Surg. 2016; 24:183–190.

12. Kim SG, Yoo B. Viscosity of dysphagia-oriented cold-thickened beverages: effect of setting time at refrigeration temperature. Int J Lang Commun Disord. 2015; 50:397–402.

13. Barbon CE, Steele CM. Characterizing the flow of thickened barium and non-barium liquid recipes using the IDDSI flow test. Dysphagia. 2019; 34:73–79.

14. Steele CM, Molfenter SM, Péladeau-Pigeon M, Stokely S. Challenges in preparing contrast media for videofluoroscopy. Dysphagia. 2013; 28:464–467.

15. Cichero J, Nicholson T, Dodrill P. Liquid barium is not representative of infant formula: characterisation of rheological and material properties. Dysphagia. 2011; 26:264–271.