The effects of aspirated thickened water on survival and pulmonary injury in a rabbit model

Nogah Nativ-Zeltzer, Maggie Kuhn, Denise Imai, Ryan P. Traslavina, Amanda S. Domer, Juliana K. Litts, Brett Adams, Peter C Belafsky

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives/Hypothesis: Liquid thickeners are one of the most frequently utilized treatment strategies for persons with oropharyngeal swallowing dysfunction. The effect of commercially available thickeners on lung injury is uncertain. The purpose of this study was to compare the effects of aspiration of water alone, xanthan gum (XG)–thickened water, and cornstarch (CS)-thickened water on survival and lung morphology in a rabbit model. Study Design: Animal model. Prospective small animal clinical trial. Methods: Adult New Zealand White rabbits (n = 24) were divided into three groups of eight rabbits. The groups underwent 3 consecutive days of 1.5 mL/kg intratracheal instillation of water (n = 8), XG-thickened water (n = 8), and CS-thickened water (n = 8). The animals were euthanized on day 4, and survival and pulmonary histopathology were compared between groups. Results: In all, 12.5% of rabbits (n = 8) instilled with CS-thickened water survived until the endpoint of the study (day 4). All animals instilled with water (n = 8) or XG-thickened water (n = 8) survived. A mild increase in intra-alveolar hemorrhage was observed for the animals instilled with CS-thickened water compared to the other groups (P <.05). In the groups that survived to the endpoint of the study, instillation of water thickened with XG resulted in greater pulmonary inflammation, pulmonary interstitial congestion, and alveolar edema than water alone (P <.05). Conclusions: These data suggest that 3 consecutive days of 1.5 mg/kg of aspirated CS-thickened water are fatal, and that XG-thickened water is more injurious than aspirated water alone. Additional research is necessary to further delineate the dangers of aspirated thickened liquids. Level of Evidence: NA. Laryngoscope, 128:327–331, 2018.

Original languageEnglish (US)
Pages (from-to)327-331
Number of pages5
JournalLaryngoscope
Volume128
Issue number2
DOIs
StatePublished - Feb 1 2018

Fingerprint

Lung Injury
Rabbits
Survival
Water
Starch
Lung
Laryngoscopes
Deglutition
Edema
Pneumonia

Keywords

  • aspiration
  • cornstarch
  • Dysphagia
  • liquid thickener
  • xanthan gum

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

The effects of aspirated thickened water on survival and pulmonary injury in a rabbit model. / Nativ-Zeltzer, Nogah; Kuhn, Maggie; Imai, Denise; Traslavina, Ryan P.; Domer, Amanda S.; Litts, Juliana K.; Adams, Brett; Belafsky, Peter C.

In: Laryngoscope, Vol. 128, No. 2, 01.02.2018, p. 327-331.

Research output: Contribution to journalArticle

Nativ-Zeltzer, Nogah ; Kuhn, Maggie ; Imai, Denise ; Traslavina, Ryan P. ; Domer, Amanda S. ; Litts, Juliana K. ; Adams, Brett ; Belafsky, Peter C. / The effects of aspirated thickened water on survival and pulmonary injury in a rabbit model. In: Laryngoscope. 2018 ; Vol. 128, No. 2. pp. 327-331.
@article{8742ee9c1ec54b40afc7ec83a9255766,
title = "The effects of aspirated thickened water on survival and pulmonary injury in a rabbit model",
abstract = "Objectives/Hypothesis: Liquid thickeners are one of the most frequently utilized treatment strategies for persons with oropharyngeal swallowing dysfunction. The effect of commercially available thickeners on lung injury is uncertain. The purpose of this study was to compare the effects of aspiration of water alone, xanthan gum (XG)–thickened water, and cornstarch (CS)-thickened water on survival and lung morphology in a rabbit model. Study Design: Animal model. Prospective small animal clinical trial. Methods: Adult New Zealand White rabbits (n = 24) were divided into three groups of eight rabbits. The groups underwent 3 consecutive days of 1.5 mL/kg intratracheal instillation of water (n = 8), XG-thickened water (n = 8), and CS-thickened water (n = 8). The animals were euthanized on day 4, and survival and pulmonary histopathology were compared between groups. Results: In all, 12.5{\%} of rabbits (n = 8) instilled with CS-thickened water survived until the endpoint of the study (day 4). All animals instilled with water (n = 8) or XG-thickened water (n = 8) survived. A mild increase in intra-alveolar hemorrhage was observed for the animals instilled with CS-thickened water compared to the other groups (P <.05). In the groups that survived to the endpoint of the study, instillation of water thickened with XG resulted in greater pulmonary inflammation, pulmonary interstitial congestion, and alveolar edema than water alone (P <.05). Conclusions: These data suggest that 3 consecutive days of 1.5 mg/kg of aspirated CS-thickened water are fatal, and that XG-thickened water is more injurious than aspirated water alone. Additional research is necessary to further delineate the dangers of aspirated thickened liquids. Level of Evidence: NA. Laryngoscope, 128:327–331, 2018.",
keywords = "aspiration, cornstarch, Dysphagia, liquid thickener, xanthan gum",
author = "Nogah Nativ-Zeltzer and Maggie Kuhn and Denise Imai and Traslavina, {Ryan P.} and Domer, {Amanda S.} and Litts, {Juliana K.} and Brett Adams and Belafsky, {Peter C}",
year = "2018",
month = "2",
day = "1",
doi = "10.1002/lary.26698",
language = "English (US)",
volume = "128",
pages = "327--331",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - The effects of aspirated thickened water on survival and pulmonary injury in a rabbit model

AU - Nativ-Zeltzer, Nogah

AU - Kuhn, Maggie

AU - Imai, Denise

AU - Traslavina, Ryan P.

AU - Domer, Amanda S.

AU - Litts, Juliana K.

AU - Adams, Brett

AU - Belafsky, Peter C

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Objectives/Hypothesis: Liquid thickeners are one of the most frequently utilized treatment strategies for persons with oropharyngeal swallowing dysfunction. The effect of commercially available thickeners on lung injury is uncertain. The purpose of this study was to compare the effects of aspiration of water alone, xanthan gum (XG)–thickened water, and cornstarch (CS)-thickened water on survival and lung morphology in a rabbit model. Study Design: Animal model. Prospective small animal clinical trial. Methods: Adult New Zealand White rabbits (n = 24) were divided into three groups of eight rabbits. The groups underwent 3 consecutive days of 1.5 mL/kg intratracheal instillation of water (n = 8), XG-thickened water (n = 8), and CS-thickened water (n = 8). The animals were euthanized on day 4, and survival and pulmonary histopathology were compared between groups. Results: In all, 12.5% of rabbits (n = 8) instilled with CS-thickened water survived until the endpoint of the study (day 4). All animals instilled with water (n = 8) or XG-thickened water (n = 8) survived. A mild increase in intra-alveolar hemorrhage was observed for the animals instilled with CS-thickened water compared to the other groups (P <.05). In the groups that survived to the endpoint of the study, instillation of water thickened with XG resulted in greater pulmonary inflammation, pulmonary interstitial congestion, and alveolar edema than water alone (P <.05). Conclusions: These data suggest that 3 consecutive days of 1.5 mg/kg of aspirated CS-thickened water are fatal, and that XG-thickened water is more injurious than aspirated water alone. Additional research is necessary to further delineate the dangers of aspirated thickened liquids. Level of Evidence: NA. Laryngoscope, 128:327–331, 2018.

AB - Objectives/Hypothesis: Liquid thickeners are one of the most frequently utilized treatment strategies for persons with oropharyngeal swallowing dysfunction. The effect of commercially available thickeners on lung injury is uncertain. The purpose of this study was to compare the effects of aspiration of water alone, xanthan gum (XG)–thickened water, and cornstarch (CS)-thickened water on survival and lung morphology in a rabbit model. Study Design: Animal model. Prospective small animal clinical trial. Methods: Adult New Zealand White rabbits (n = 24) were divided into three groups of eight rabbits. The groups underwent 3 consecutive days of 1.5 mL/kg intratracheal instillation of water (n = 8), XG-thickened water (n = 8), and CS-thickened water (n = 8). The animals were euthanized on day 4, and survival and pulmonary histopathology were compared between groups. Results: In all, 12.5% of rabbits (n = 8) instilled with CS-thickened water survived until the endpoint of the study (day 4). All animals instilled with water (n = 8) or XG-thickened water (n = 8) survived. A mild increase in intra-alveolar hemorrhage was observed for the animals instilled with CS-thickened water compared to the other groups (P <.05). In the groups that survived to the endpoint of the study, instillation of water thickened with XG resulted in greater pulmonary inflammation, pulmonary interstitial congestion, and alveolar edema than water alone (P <.05). Conclusions: These data suggest that 3 consecutive days of 1.5 mg/kg of aspirated CS-thickened water are fatal, and that XG-thickened water is more injurious than aspirated water alone. Additional research is necessary to further delineate the dangers of aspirated thickened liquids. Level of Evidence: NA. Laryngoscope, 128:327–331, 2018.

KW - aspiration

KW - cornstarch

KW - Dysphagia

KW - liquid thickener

KW - xanthan gum

UR - http://www.scopus.com/inward/record.url?scp=85040651645&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040651645&partnerID=8YFLogxK

U2 - 10.1002/lary.26698

DO - 10.1002/lary.26698

M3 - Article

VL - 128

SP - 327

EP - 331

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

IS - 2

ER -