Background Aspiration of fluids is a significant problem of neurological impairments

Background Aspiration of fluids is a significant problem of neurological impairments such as for example traumatic human brain heart stroke or damage. etiology of neurogenic dysphagia. This research has an interesting brand-new perspective not really previously investigated for the reason that it includes a bigger people of diffuse accidents (TBI) than prior research. In this test, Pentagastrin 90% from the individuals who responded favorably to CARB were in the TBI category. There are some limitations of this study that must be considered when designing further research in this area. Larger population samples are needed to help draw more conclusive results, in particular including more participants who have impaired swallowing as exhibited on videofluoroscopic swallow studies to strengthen the eventual conclusions, perhaps using a prospective, case-control design. Further, inclusion of more participants at the younger end of the age range would strengthen eventual findings, as the age distribution in this study was skewed toward higher ages. A blinded review process and counterbalancing of the experimental conditions should be considered as well. Counterbalanced presentation may help avoid a bias affecting the various outcome variables, as the order of presentation may have affected more than just the residue outcome. Inclusion of Pentagastrin swallows of both NOCARB and CARB by straw during this study, though not specifically measured, allowed speech-language pathologists to evaluate participants for functional drinking to inform diet recommendations but may have contributed to fatigue or other potential confounding variables. Consideration should be taken to evaluate study variables separately, and then utilize standard assessment procedures to establish a safe diet for participants. Enhanced technology would allow for the inclusion of more refined measurements for variables such as pharyngeal transit time (e.g., Bulow et al. [16] and Sdravou et al. [17]) and pharyngeal residue (e.g., Sdravou et al. [17] and Pearson et al. [46]), and may enhance reliability for measurements such as pooling and residue. The recording rate used in this study was based on an American College of Radiology white paper summary [47] and papers discussing the application of the ALARA theory in pediatric studies (e.g., Strauss & Kaste [48] and Cohen [49]). Since the Pentagastrin completion of data collection for this project, one study has been published that found increased likelihood of not detecting supraglottic penetration of barium using 15 fps in videofluoroscopic swallow studies with children [50]. It is a possible limitation of this study that the recording rate may have resulted in missed instances of laryngeal penetration. No studies have been published that show missed aspiration events in children using 15 fps, though it is now a standard recommendation that videofluoroscopic swallow studies using digital gear record at 30 fps to most clearly identify swallowing impairment and make treatment recommendations in adult studies (e.g., Bonilha et al. [51]). Additional directions for future research include larger or varied volumes of barium GF1 (e.g., Sdravou et al. [17]) with children and adolescents using CARB to ensure, for example, that children would be safe to drink a carbonated liquid through a straw once they return to their unit on the hospital floor. As most studies, including the present study, have examined the effects of barium after immediate carbonation, it will be important to monitor carbonated beverages to determine how rapidly the carbon dioxide concentration changes within the liquid. Researchers may need to further determine if a less-carbonated beverage affects swallowing performance. Perhaps there is an optimal level of carbonation needed to stimulate the mechanoreceptors, chemoreceptors, nociceptors and thermoreceptors in the pharynx and larynx to stimulate the protective reflexes that aid in Pentagastrin aspiration prevention [32]. Even if CARB does show in the future to be an effective treatment strategy for neurogenic dysphagia, it will need to be carefully assessed on a case-by-case basis using videofluoroscopic swallow studies. As seen in this study, there was one participant (patient 15) who aspirated CARB after safely handling NOCARB. Each individual with dysphagia must be individually evaluated to ensure that CARB will affect his/her.

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