Characterizing the Flow of Thickened Barium and Non-barium Liquid Recipes Using the IDDSI Flow Test.
Carly E A Barbon, Catriona M Steele
PMID 29948262WHAT IT FOUND
Tested barium recipes could be made to match IDDSI slightly to moderately thick levels and stay stable over time, but adding barium often thickened liquids more than the same non-barium recipe.
Key findings
01More thickener made the liquids thicker, and the pattern was statistically significant for all four liquid types.
02Across time, none of the recipes shifted across IDDSI level boundaries.
03For the non-barium starch-thickened liquid, thickness increased significantly within the same IDDSI level between the 1- and 2-hour checks and between the 2- and 3-hour checks; the other liquids did not show this.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study tested only two thickeners and one barium sulfate suspension, so the recipes may not transfer to other brands or products. The liquids were made with bottled water and lemon-flavored water; other clinical liquids, such as infant formula or breastmilk, were not tested. The study measured syringe flow, not swallowing, aspiration, residue, or patient outcomes, so it does not show that these recipes are clinically safer. Some flow results fell close to IDDSI boundaries, and the authors recommend targeting the middle of each range because small differences in flow have unclear clinical significance. The temperature comparison was preliminary and tested only barium recipes at room temperature and about 4 degrees Celsius.
Declared interests
The NIH funded the work, and the authors declared no competing interests.
The easy way to misread this
Do not copy a non-barium thickener amount straight into a barium mixture and assume the IDDSI level will be the same. The study showed barium can thicken the liquid further, and the tested interactions were specific to the brands studied.