Comparison of standardized bariums with varying rheological parameters on swallowing kinematics in males

This study measured dose-response of a range of commercially available liquid barium materials designed for use in videofluoroscopic oropharyngeal swallowing assessments, par-ticularly as they relate to the necessity of adding a thickening agent for swallow safety. A group of 25 adult males representing various medical diagnoses consented to participate, with 16 quali-fying to complete a videofluoroscopic swallowing assessment with liquid barium materials of three viscosities (nectar: 300 cP, thin honey: 1, 500 cP, thick honey: 3, 000 cP). Outcome measures included airway invasion (Penetration-Aspiration score), post-swallow residue, and patient preference. Penetration-Aspiration and residue scores did not significantly differ between thin honey and thick honey bariums. Significantly more severe airway inva-sion was observed with nectar boluses than with two levels of honey boluses (p < 0.001). Significantly more residue was observed in the oral cavity (p < 0.002) and valleculae (p < 0.001) with thin and thick honey bariums than with nectar barium. Thin honey was rated as "easy" or "average" to drink by 67% of sub-jects, compared with 54% for thick honey. This study supports the use of thin honey barium over thick honey barium during video-fluoroscopic swallowing assessments because the two honey bari-ums were comparable in terms of airway protection and postswallow residue in the oropharynx and the thin honey was preferred by patients.