Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico

Detalhes bibliográficos
Autor(a) principal: Hernandez, Ana Maria
Data de Publicação: 2020
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_SP
Texto Completo: https://tede2.pucsp.br/handle/handle/23492
Resumo: Videofluoroscopy swallow studies are considered the gold standard for the dysphagia diagnosis. For greater confidence in the result, it is necessary to know the performance of the infant replicating the normal function situation, whether in terms of the form of offer, the mother's breast, as well as in the preparation of the of the liquid to be offered. To achieve this purpose, the research was divided into three studies. Study I – Analiyses of neonates and infants in breast-feeding and bottle feeding, aimed at assess the similarities and differences on infant swallowing dynamics secondary to the stimulus offered and the possible impacts on the videofluoroscopy swallowing study findings. A retrospective study of twenty five videofluoroscopy swallowing study was carried out in the two types of offer – breast and bottle. The results showed a statistically significant association between the two types of offer specially related to velar function. The study II – Rheological analyses of liquids offered in videofluoroscopy swallow study of neonates and infants, aimed at analysing the rheological properties of liquids usually presented during videofluosocopy swallow studies in Brazil. The greater similarity in the rheological properties of the fluids offered to those of the infant’s typical diet, greater precision in the diagnosis and safe diet prescription obtained. The findings of the study II allowed not only the rheological characterization of the samples, but deeper understanding of how their viscosities behave in deformation rates consistent with the conditions provided in the act of deglutition. Rheological evaluation is effective in obtaining quantitative data on the properties of liquids. However it constitutes a high-cost technique that depends on expensive equipment and its not available to the broader clinical population and health professionals. Hence, an attempt was made to research and compare a proposal for a simple and affordable evaluation of the viscosity of liquids.The Study III – Analysis of the flow of isolated liquids and in addition of barium sulfate according to the model proposed by International Dysphagia Diet Standardization Iniciative, aimed at analyse the fluidity of the same products evaluated in study II, using the model proposed by the International Dysphagia Diet Standartization Iniciative. The results of two sudies were compared and indicated that liquids with viscosity differences from 2 to 4 mL in the International Dysphagia Diet Standardization Iniciative, are classified in the same category l. Similar findings were obtained in the rheological study where, despite the 18 to eighteen and a half folds in liquid viscosity, the classificacion remains in the same category.The current research supports the idea and allowed to conclude that greater reliability wil be obtained in the diagnosis of the swallowing dynamics of neonates and infants in breast-feeding by replicating, as close as possible, the usual conditions of offer, considering the familiar form – breast-feeding, utensils of suply, as well, taking care on preparation and control of the liquids viscosity. This is particulary crucial in the pediatric evaluation to facilitate optimal participation and confidence on the results. In conclusion, it will contribute to the best professional practices in the clinic for dysphagic patients or those at risk for dysphagia, being able to indicate the best and safier diet for the patient, facilitating the control in the handling of the offer by their caregivers. This should avoid the risk of inaccurate diagnosis of deglutition function, that may result in unnecessary intervention like an early weaning or risk for pulmonary health
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spelling Bianchini, Esther Mandelbaum Gonçalveshttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4247245H1Hernandez, Ana Maria2021-03-04T09:45:42Z2020-11-30Hernandez, Ana Maria. Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico. 2020. 152 f. Tese (Doutorado em Fonoaudiologia) - Programa de Estudos Pós-Graduados em Fonoaudiologia, Pontifícia Universidade Católica de São Paulo, São Paulo, 2020.https://tede2.pucsp.br/handle/handle/23492Videofluoroscopy swallow studies are considered the gold standard for the dysphagia diagnosis. For greater confidence in the result, it is necessary to know the performance of the infant replicating the normal function situation, whether in terms of the form of offer, the mother's breast, as well as in the preparation of the of the liquid to be offered. To achieve this purpose, the research was divided into three studies. Study I – Analiyses of neonates and infants in breast-feeding and bottle feeding, aimed at assess the similarities and differences on infant swallowing dynamics secondary to the stimulus offered and the possible impacts on the videofluoroscopy swallowing study findings. A retrospective study of twenty five videofluoroscopy swallowing study was carried out in the two types of offer – breast and bottle. The results showed a statistically significant association between the two types of offer specially related to velar function. The study II – Rheological analyses of liquids offered in videofluoroscopy swallow study of neonates and infants, aimed at analysing the rheological properties of liquids usually presented during videofluosocopy swallow studies in Brazil. The greater similarity in the rheological properties of the fluids offered to those of the infant’s typical diet, greater precision in the diagnosis and safe diet prescription obtained. The findings of the study II allowed not only the rheological characterization of the samples, but deeper understanding of how their viscosities behave in deformation rates consistent with the conditions provided in the act of deglutition. Rheological evaluation is effective in obtaining quantitative data on the properties of liquids. However it constitutes a high-cost technique that depends on expensive equipment and its not available to the broader clinical population and health professionals. Hence, an attempt was made to research and compare a proposal for a simple and affordable evaluation of the viscosity of liquids.The Study III – Analysis of the flow of isolated liquids and in addition of barium sulfate according to the model proposed by International Dysphagia Diet Standardization Iniciative, aimed at analyse the fluidity of the same products evaluated in study II, using the model proposed by the International Dysphagia Diet Standartization Iniciative. The results of two sudies were compared and indicated that liquids with viscosity differences from 2 to 4 mL in the International Dysphagia Diet Standardization Iniciative, are classified in the same category l. Similar findings were obtained in the rheological study where, despite the 18 to eighteen and a half folds in liquid viscosity, the classificacion remains in the same category.The current research supports the idea and allowed to conclude that greater reliability wil be obtained in the diagnosis of the swallowing dynamics of neonates and infants in breast-feeding by replicating, as close as possible, the usual conditions of offer, considering the familiar form – breast-feeding, utensils of suply, as well, taking care on preparation and control of the liquids viscosity. This is particulary crucial in the pediatric evaluation to facilitate optimal participation and confidence on the results. In conclusion, it will contribute to the best professional practices in the clinic for dysphagic patients or those at risk for dysphagia, being able to indicate the best and safier diet for the patient, facilitating the control in the handling of the offer by their caregivers. This should avoid the risk of inaccurate diagnosis of deglutition function, that may result in unnecessary intervention like an early weaning or risk for pulmonary healthA videofluoroscopia é considerada padrão ouro para diagnóstico das disfagias. Para maior confiança no resultado, faz-se necessário conhecer o desempenho do neonato ou lactente replicando a situação normal de oferta seja quanto à forma, seio materno, como no preparo do alimento a ser ofertado. Para esse propósito o projeto foi dividido em três estudos. Estudo I - Análise da deglutição de neonatos e lactentes em aleitamento materno e mamadeira, teve por objetivo analisar as similaridades e diferenças na dinâmica da deglutição de neonatos e lactentes em oferta do seio materno e mamadeira, e possíveis impactos na deglutição em decorrência do tipo de oferta em exame videofluoroscópico. Foi realizado estudo retrospectivo de vinte e cinco videofluoroscopias, nas duas formas de oferta – seio e mamadeira. Os resultados mostraram associação estatisticamente significativa entre as variáveis e os dois tipos de oferta, em especial no que se refere à função velar. O Estudo II – Análise reológica dos líquidos oferecidos em exame de videofluoroscopia de neonatos e lactentes, teve por objetivo analisar as propriedades reológicas dos líquidos utilizados em exame de videofluoroscopia no Brasil. Quanto maior semelhança nas propriedades reológicas dos líquidos ofertados no exame àquelas dos alimentos ofertados em sua vida diária, maior precisão no diagnóstico e na indicação da dieta segura para o paciente. Foram analisados líquidos de uso frequente para a população de zero a seis meses, avaliados puros, em formulação com sulfato de bário em duas proporções, 20 e 33%. Utilizou-se também as formulações com um espessante. Os achados do estudo reológico permitiram a caracterização reológica das amostras e o entendimento mais aprofundado de como se comporta a viscosidade destas, em taxas de deformação condizentes com as condições proporcionadas no ato de deglutição. Entretanto a avaliação reológica, eficaz na obtenção de dados quantitativos das propriedades dos líquidos, se constitui em técnica de alto custo. Buscou-se pesquisar e comparar uma proposta de avaliação da viscosidade dos líquidos simples e acessível. Estudo III - Análise do fluxo de líquidos isolados e em adição de sulfato de bário segundo modelo proposto pela International Dysphagia Diet Standardisation Initiative teve por objetivo analisar a fluidez dos mesmos produtos avaliados no estudo II, utilizando a proposta de classificação pela International Dysphagia Diet Standardisation Initiative. Os resultados dois dois estudos foram comparados e indicaram que líquidos com diferenças de viscosidade da ordem de 2 a 4 mL no teste da International Dysphagia Diet Standardisation Initiative estão classificados em uma mesma categoria. Achados semelhante foram obtidos no estudo reológico em que, apesar do aumento da viscosidade de 18 a dezoito vezes e meia, a classificação permanece a mesma. A presente pesquisa sustentou a idéia e permitiu concluir que se obterá maior confiabilidade no diagnóstico da dinâmica da deglutição de neonatos e lactentes em aleitamento materno ao garantir a similaridade das condições específicas da oferta alimentar em exame de videofluoroscopia, tanto no que se refere à forma familiar- seio materno, utensílio, quanto ao preparo e controle da viscosidade do estímulo. São condições particularmente cruciais na avaliação pediátrica, facilitando a cooperação do paciente, e confiança no diagnóstico. Poderá evitar o risco de um diagnóstico impreciso da função de deglutição, que pode resultar em intervenções deletérias, se desnecessárias, como o desmame precoce ou que coloque em risco a saúde pulmonar do pacienteCoordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESapplication/pdfhttp://tede2.pucsp.br/tede/retrieve/53251/Ana%20Maria%20Hernandez.pdf.jpgporPontifícia Universidade Católica de São PauloPrograma de Estudos Pós-Graduados em FonoaudiologiaPUC-SPBrasilFaculdade de Ciências Humanas e da SaúdeDiagnóstico videofluoroscópicoDeglutiçãoDisfagiaVideofluoroscopy diagnosisDeglutitionDysphagiaCNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIAAnálise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópicoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_SPinstname:Pontifícia Universidade Católica de São Paulo (PUC-SP)instacron:PUC_SPTEXTAna Maria Hernandez.pdf.txtAna Maria Hernandez.pdf.txtExtracted texttext/plain247244https://repositorio.pucsp.br/xmlui/bitstream/handle/23492/4/Ana%20Maria%20Hernandez.pdf.txtdd4a833dfd5e2b56908c298a90565156MD54LICENSElicense.txtlicense.txttext/plain; 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dc.title.por.fl_str_mv Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico
title Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico
spellingShingle Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico
Hernandez, Ana Maria
Diagnóstico videofluoroscópico
Deglutição
Disfagia
Videofluoroscopy diagnosis
Deglutition
Dysphagia
CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA
title_short Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico
title_full Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico
title_fullStr Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico
title_full_unstemmed Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico
title_sort Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico
author Hernandez, Ana Maria
author_facet Hernandez, Ana Maria
author_role author
dc.contributor.advisor1.fl_str_mv Bianchini, Esther Mandelbaum Gonçalves
dc.contributor.authorLattes.fl_str_mv http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4247245H1
dc.contributor.author.fl_str_mv Hernandez, Ana Maria
contributor_str_mv Bianchini, Esther Mandelbaum Gonçalves
dc.subject.por.fl_str_mv Diagnóstico videofluoroscópico
Deglutição
Disfagia
topic Diagnóstico videofluoroscópico
Deglutição
Disfagia
Videofluoroscopy diagnosis
Deglutition
Dysphagia
CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA
dc.subject.eng.fl_str_mv Videofluoroscopy diagnosis
Deglutition
Dysphagia
dc.subject.cnpq.fl_str_mv CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA
description Videofluoroscopy swallow studies are considered the gold standard for the dysphagia diagnosis. For greater confidence in the result, it is necessary to know the performance of the infant replicating the normal function situation, whether in terms of the form of offer, the mother's breast, as well as in the preparation of the of the liquid to be offered. To achieve this purpose, the research was divided into three studies. Study I – Analiyses of neonates and infants in breast-feeding and bottle feeding, aimed at assess the similarities and differences on infant swallowing dynamics secondary to the stimulus offered and the possible impacts on the videofluoroscopy swallowing study findings. A retrospective study of twenty five videofluoroscopy swallowing study was carried out in the two types of offer – breast and bottle. The results showed a statistically significant association between the two types of offer specially related to velar function. The study II – Rheological analyses of liquids offered in videofluoroscopy swallow study of neonates and infants, aimed at analysing the rheological properties of liquids usually presented during videofluosocopy swallow studies in Brazil. The greater similarity in the rheological properties of the fluids offered to those of the infant’s typical diet, greater precision in the diagnosis and safe diet prescription obtained. The findings of the study II allowed not only the rheological characterization of the samples, but deeper understanding of how their viscosities behave in deformation rates consistent with the conditions provided in the act of deglutition. Rheological evaluation is effective in obtaining quantitative data on the properties of liquids. However it constitutes a high-cost technique that depends on expensive equipment and its not available to the broader clinical population and health professionals. Hence, an attempt was made to research and compare a proposal for a simple and affordable evaluation of the viscosity of liquids.The Study III – Analysis of the flow of isolated liquids and in addition of barium sulfate according to the model proposed by International Dysphagia Diet Standardization Iniciative, aimed at analyse the fluidity of the same products evaluated in study II, using the model proposed by the International Dysphagia Diet Standartization Iniciative. The results of two sudies were compared and indicated that liquids with viscosity differences from 2 to 4 mL in the International Dysphagia Diet Standardization Iniciative, are classified in the same category l. Similar findings were obtained in the rheological study where, despite the 18 to eighteen and a half folds in liquid viscosity, the classificacion remains in the same category.The current research supports the idea and allowed to conclude that greater reliability wil be obtained in the diagnosis of the swallowing dynamics of neonates and infants in breast-feeding by replicating, as close as possible, the usual conditions of offer, considering the familiar form – breast-feeding, utensils of suply, as well, taking care on preparation and control of the liquids viscosity. This is particulary crucial in the pediatric evaluation to facilitate optimal participation and confidence on the results. In conclusion, it will contribute to the best professional practices in the clinic for dysphagic patients or those at risk for dysphagia, being able to indicate the best and safier diet for the patient, facilitating the control in the handling of the offer by their caregivers. This should avoid the risk of inaccurate diagnosis of deglutition function, that may result in unnecessary intervention like an early weaning or risk for pulmonary health
publishDate 2020
dc.date.issued.fl_str_mv 2020-11-30
dc.date.accessioned.fl_str_mv 2021-03-04T09:45:42Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
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dc.identifier.citation.fl_str_mv Hernandez, Ana Maria. Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico. 2020. 152 f. Tese (Doutorado em Fonoaudiologia) - Programa de Estudos Pós-Graduados em Fonoaudiologia, Pontifícia Universidade Católica de São Paulo, São Paulo, 2020.
dc.identifier.uri.fl_str_mv https://tede2.pucsp.br/handle/handle/23492
identifier_str_mv Hernandez, Ana Maria. Análise da deglutição de neonatos e lactentes: impacto da forma de oferta e viscosidade do estímulo no diagnóstico videofluoroscópico. 2020. 152 f. Tese (Doutorado em Fonoaudiologia) - Programa de Estudos Pós-Graduados em Fonoaudiologia, Pontifícia Universidade Católica de São Paulo, São Paulo, 2020.
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dc.publisher.program.fl_str_mv Programa de Estudos Pós-Graduados em Fonoaudiologia
dc.publisher.initials.fl_str_mv PUC-SP
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Faculdade de Ciências Humanas e da Saúde
publisher.none.fl_str_mv Pontifícia Universidade Católica de São Paulo
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repository.name.fl_str_mv Biblioteca Digital de Teses e Dissertações da PUC_SP - Pontifícia Universidade Católica de São Paulo (PUC-SP)
repository.mail.fl_str_mv bngkatende@pucsp.br||rapassi@pucsp.br
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