Study on the Correlation between Barium Radiography and Pulmonary Infection rate in the Evaluation of Swallowing Function

Jie Sun,Zeheng Li

doi:10.6061/clinics/2018/e182

Abstract

OBJECTIVES:To compare the results respectively obtained from the utilization of 60% barium sulfate suspension and Iohexol as contrast agents for videofluoroscopic swallowing studies and the relationship between the clinical application of the two kinds of contrast agents and the incidence of pneumonia.METHODS:Sixty cases of stroke patients with dysphagia were selected in rehabilitation department of our hospital, and the gender, age, position of the disease, and stroke nature between groups had no significant difference. Among which, 30 patients who were administered 350 mgI/ml Iohexol, and the other 30 patients with 60% barium sulfate suspension as contrast agent. We performed videofluoroscopic swallowing studies with barium 60% versus Iohexol within 1 week after admission and 2 weeks after admission.RESULTS:After 2 weeks in hospital, the aspiration pneumonia incidence of two groups was statistically significant (p<0.05), the pneumonia incidence of Iohexol group was lower than barium sulfate group which might have a impossble relevance with barium aspiration.CONCLUSIONS:During the videofluoroscopic swallowing study of dysphagia after stroke, barium sulfate can enhance the pneumonia incidence, and Iohexol can be widely applied in videofluoroscopic swallowing study.

Highlights

As a common clinical disease, stroke can result in hemiplegia and other somatic movement dysfunctions, and lead to different degrees of dysphagia after stroke (DAS)
Barium sulfate suspension prepared by 150 g barium powder +100 ml water; semifluid barium sulfate was a pasty barium sulfate food prepared by 60 ml 60% barium sulfate suspension +1g thickener; pasty barium sulfate was a pasty barium sulfate food prepared by 60 ml 60% barium sulfate suspension +2 g thickener; solid barium sulfate was made by painting semisolid contrast agent, prepared by 60% barium sulfate suspension, on graham bread
The generation mechanism of dysphagia after stroke has been proved to be related with the following sites, including cortex, cortex downward projection, cerebellar and extrapyramidal abnormalities, sensory deprivation and loss of cranial nerve related to swallowing

Summary

Introduction

As a common clinical disease, stroke can result in hemiplegia and other somatic movement dysfunctions, and lead to different degrees of dysphagia after stroke (DAS). It has been reported that (1) 37%-74% of acute stroke patients had different degrees of dysphagia and 37% of aspiration patients could develop into pneumonia. Videofluoroscopic swallowing (VFSS) study is the most common method to examine swallowing function and has proved to be the early diagnostic basis of dysphagia. The common method in domestic clinic is to add the right amount of water into barium sulfate powder to make 60% barium sulfate suspension.

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