Diagnosis and Management of Oropharyngeal Dysphagia and Its Nutritional and Respiratory Complications in the Elderly
Figure 3
Algorithms of bolus volume and viscosity administration during V-VST. The strategy of the V-VST aims at protecting patients from aspiration by starting with nectar viscosity and volumes were increased from 5 mL, to 10 mL and 20 mL boluses in a progression of increasing difficulty. When patients completed the nectar series without major symptoms of aspiration (cough and/or fall in oxygen saturation ≥3%), a less “safe” liquid viscosity series was assessed also with boluses of increasing difficulty (5 mL to 20 mL). Finally, a more “safe” pudding viscosity series (5 mL to 20 mL) was assessed using similar rules. If the patient presents a sign of impaired safety at nectar viscosity, the series is interrupted, the liquid series is omitted, and a more safe pudding viscosity series is assessed. If the patient presents a sign of impaired safety at liquid viscosity, the liquid series is interrupted and the pudding series is assessed (Figure 1).
