ESPEN 2012 - Late breaking abstract submission

Topic: Late Breaking Abstract

Abs n°:ESPEN12-1875

Abs Title: THERAPEUTIC EFFECT OF XANTHAN GUM-BASED THICKENER ON SWALLOWING FUNCTION IN PATIENTS WITH OROPHARYNGEAL DYSPHAGIA

L. Rofes ^1,*V. Arreola ²R. Mukherjee ³P. Clavé ¹

¹CIBERehd - Hospital de Mataró, ²Hospital de Mataró, Mataró, Spain, ³Nestlé Research Center, Nestec Ltd, Lausanne, Switzerland

Rationale: Oropharyngeal dysphagia (OD) is a major contributor to malnutrition. Starch-based thickeners improve safety of deglutition but increase residue. We aimed to evaluate the therapeutic effect of a xanthan gum-based thickener, Resource® ThickenUp Clear (RTUC, Nestlé Health Science).

Methods: We studied 120 patients with OD with videofluoroscopy while swallowing a series of 5-20 mL liquid boluses at nectar, thin and extreme spoon-thick (EST) viscosities measured at 50/s 20°C and obtained with a hydrosoluble X-Ray contrast (50/50 vol with water) and RTUC. We assessed prevalence of penetrations and aspirations for impaired safety, oropharyngeal residue for impaired efficacy, bolus velocity, timing of the swallow response, and the nutritional risk (MNASF, NRS 2002).

Results: Prevalence of malnutrition or risk of malnutrition was 71% according to MNA-SF and 76% according to NRS 2002. Increasing bolus viscosity: a) improved safety of swallow as 24% of patients with OD presented safe swallow at thin, 55% at nectar (P<0.001) and 85% at EST (P<0.001). Prevalence of aspiration was 16% at thin, 9% at nectar (P<0.01) and 5% at EST (P<0.01). The score of the penetration-aspiration scale was 3.3±0.2 (thin), 2.2±0.2 ( P<0.001, nectar) and 1.5±0.1 (P<0.001, EST); b) did not enhance oropharyngeal residue; c) did not affect timing of swallow response; d) reduced bolus velocity from 0.25±0.01m/s at thin to 0.21±0.01m/s at EST (P<0.05).

Conclusion: Prevalence of malnutrition among neurological and older patients with OD is very high. Increasing bolus viscosity with RTUC exerts a strong therapeutic effect by improving the safety of swallow without increasing oropharyngeal residue, an advantage of new generation versus conventional thickening agents. This effect might help to improve the nutritional treatments for these patients.

Disclosure of Interest: L. Rofes: None DeclaredV. Arreola: None DeclaredR. Mukherjee: None DeclaredP. Clavé Grant/Research Support from: Nestec Ltd

Keywords: Dysphagiamalnutrition