[Dysphagia] Logemann Robbins results

[eripley at yahoo.com (Irene Campbell-Taylor)]

The already existing literature seems to argue that not enough water is supplied and that even when patients drink all of the thickened fluids given, they still do not ingest/absorb enough water.
  Among other articles see:
  Inadequate fluid intakes in dysphagic acute stroke
  K.WHELAN
  Department of Nutrition and Dietetics, Kings College London, UK. (Correspondence to: KW, Research Dietitian, Department of
  Nutrition and Dietetics, Kings College London,150 Stamford Street, London, SE19NN, UK)
  Clinical Nutrition (2001) 20(5): 423?428
   

"Cameron, Sharon (R3)" <Sharon.Cameron at rvh.nb.ca> wrote:    As a Dietitian on the list, unfortunately I have not been privy to the
ASHA information. 

My question for those familiar with the research is a question about the
dehydration associated with thickened fluids. 
   
  

Is it a question that the fluid is bound by and therefore not available
to the body once thickened (more of a concern with gel thickeners) or is
it a question that once recommended, patients do not drink adequate
quantities of thickened fluids ? 

Any info greatly appreciated


Sharon Cameron
Registered Dietitian
Stan Cassidy Centre for Rehabilitation
800 Priestman Street
Fredericton, NB E3B 0C7
506-452-5652


-----Original Message-----
From: dysphagia-bounces at dysphagia.com
[mailto:dysphagia-bounces at dysphagia.com] On Behalf Of Irene
Campbell-Taylor
Sent: Wednesday, May 09, 2007 11:57 AM
To: dysphagia at b9.com
Subject: [Dysphagia] Logemann Robbins results

For those who have difficulty with the links, the following is taken
from the original presentation at ASHA 2006:

Major Findings
Long term results show that despite differential effect of
interventions on immediate elimination of aspiration in
videofluoroscopic suite (Part I findings)......the 3-month incidence of
pneumonia was similar for chin down posture compared to thickened
liquids

( This, of course, emphasises again that what is seen on VFSS is not
necessarily what happens in real life.)

Adverse Events Hospitalization
Dehydration
(Presumably hospitalization for pneumonia and/or effects of
dehydration.)
Dehydration No difference in measured parameters Subset: n=16
Serum osmolality
Sodium
BUN (mg/dL)
Serum creatine (mg/dL)
Defined by primary physician
Was more frequent in thickened liquid arms (6% vs. 2%, p<0.05) 

Current Clinical Notion
"The thicker the liquid, the safer the swallow"
*Not true in patients who aspirate thick liquids - worse health
outcomes





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