[Dysphagia] Project 201

[sem at new-vis.com (Suzanne Morris)]

I have a few questions for you, Irene, related to your sharing of the  
Project 201 study:

I found the data from this research very interesting, but had a  
question as I've been trying to put together the viscosity  
conclusions with the pneumonia conclusions.   You've emphasized in  
your many posts that pneumonia is caused predominantly by aspiration  
of reflux, not aspiration of food or liquid going down.  The major  
variable here is the health of the patient and the overall  
cleanliness of the mouth.   Yet, this study used the incidence of  
pneumonia (presumably from aspiration of the food as the major  
variable.   Do you know whether they actively controlled for the  
presence of reflux?  the general state of immune system strength/ 
health, and oral hygiene in the different groups of patients whom  
they studied?   If not, is it possible that the increased pneumonia  
in the group that took honey-thick liquids was related to a factor  
other than the viscosity?   Also, since patients are less likely to  
drink fluids that are overly thickened, the amount of dehydration  
could also have been a variable.  Perhaps the highest level of  
pneumonia in patients who drank honey-thick liquids was related to  
reduced overall health from dehydration.

  I'm interested in your perception of this and whether in the actual  
study these factors were considered in the basic design.
Suzanne
__________________________________
Suzanne Evans Morris, Ph.D.
Speech-Language Pathologist
New Visions
1124 Roberts Mountain Rd.
Faber, VA 22938
(434) 361-2285 ext. 5
www.new-vis.com

On Nov 20, 2006, at 12:53 PM, Irene Campbell-Taylor wrote:
The recent presentation of results from Project 201 are interesting  
even though entirely predictable:
   Dehydration was significantly more prevalent in patients on  
thickened fluids (p =<05) (as assessed by physician.)
   No significant difference between chin down and thickened liquids  
? both groups developed pneumonia.
   ?Honey thick? associated with  twice as much pneumonia as ?nectar?.
   VFSS results did not carry over to real life situation.
   ?Current Clinical Notion? : The thicker the liquid the safer the  
swallow ? Not true in patients who aspirate thick liquids ? worse  
health outcomes. Caution advised.
   (The important message is that patients do aspirate thick liquids.)


Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com