Effect of Pulse Rate on Judgments of Airway Compromise Events During Infant Modified Barium Swallow Studies

Memorie M. Gosa, Anneliese C. Bolland


Purpose:  This research project sought to determine the effect of pulse rate on judgments of moderate to severe airway compromise events during infant MBSS. 

Method:  This retrospective analysis investigated potential differences in Penetration Aspiration Scale (PAS) scores for swallows viewed at three different simulated pulse rate conditions by providing video files for review that featured 30 images per second (ips), 15 ips, and 7.5 ips.  Analysts who were trained to achieve high consensus scored 20 different infant swallows recorded during MBSS at each of the simulated pulse rate conditions using the PAS. 

Result: Significant differences in PAS scores were found between infant MBSS reviewed at 30 pps and simulated 7.5 pps, with scores lower at simulated 7.5 pps, indicating analysts perceived less severe airway compromise events during the infant MBSS reviewed at lower pulse rates.

Conclusion:  The results from this research study indicate that the accurate identification of airway compromise events is affected by the pulse rate applied during the infant MBSS.


Infant, Modified Barium Swallow Study, Pulse Rate, Aspiration, Dysphagia, Videofluoroscopic Swallow Study

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Lefton-Greif MA, McGrath-Morrow SA. Deglutition and respiration: development, coordination, and practical implications. Seminars in speech and language. Aug 2007;28(3):166-179.

Kramer SS, Eicher PM. The evaluation of pediatric feeding abnormalities. Dysphagia. 1993;8(3):215-224.

Lefton-Greif MA. Pediatric dysphagia. Physical medicine and rehabilitation clinics of North America. Nov 2008;19(4):837-851, ix.

Benson JE, Lefton-Greif MA. Videofluoroscopy of swallowing in pediatric patients: a component of the total feeding evaluation. In: Tuchman DN, Walter RS, eds. Disorders of feeding and swallowing in infants and children: pathophysiology, diagnosis, and treatment. 1 ed. San Diego, California: Singular Publishing Group; 1994:187-200.

Newman LA. Optimal care patterns in pediatric patients with dysphagia. Seminars in speech and language. 2000;21(4):281-291.

Bamford O, Taciak V, Gewolb IH. The relationship between rhythmic swallowing and breathing during suckle feeding in term neonates. Pediatric research. Jun 1992;31(6):619-624.

Martin-Harris B, Logemann JA, McMahon S, Schleicher M, Sandidge J. Clinical utility of the modified barium swallow. Dysphagia. Summer 2000;15(3):136-141.

Hernanz-Schulman M, Goske MJ, Bercha IH, Strauss KJ. Pause and pulse: ten steps that help manage radiation dose during pediatric fluoroscopy. AJR. American journal of roentgenology. Aug 2011;197(2):475-481.

Weir KA, McMahon SM, Long G, et al. Radiation doses to children during modified barium swallow studies. Pediatr Radiol. Mar 2007;37(3):283-290.

Newman LA. Videofluoroscopy in Infant and Pediatric Populations. SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia). 2007;16:11-15.

Bonilha HS, Blair J, Carnes B, et al. Preliminary investigation of the effect of pulse rate on judgments of swallowing impairment and treatment recommendations. Dysphagia. Dec 2013;28(4):528-538.

Hiorns MP, Ryan MM. Current practice in paediatric videofluoroscopy. Pediatr Radiol. Sep 2006;36(9):911-919.

Cohen MD. Can we use pulsed fluoroscopy to decrease the radiation dose during video fluoroscopic feeding studies in children? Clinical radiology. 2009;64:70-73.

Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. Spring 1996;11(2):93-98.

McCullough GH, Rosenbek JC, Robbins JA, Coyle JL, Wood JL. Ordinality and intervality of a penetration-aspiration scale. Journal of Medical Speech Language Pathology. 1998;6:65-72.

Gosa MM, Suiter DM. Reliability of the penetration-aspiration scale for use with infants and children [abstract]. In: Shaker R, ed. Dysphagia Research Society 19th Annual Meeting Vol 26. San Antonio, TX: Springer; 2011:432-475.

Tutor JD, Gosa MM. Dysphagia and aspiration in children. Pediatric pulmonology. Apr 2012;47(4):321-337.

Dodrill P, Gosa MM. Pediatric Dysphagia: Physiology, Assessment, and Management. Ann Nutr Metab. 2015;66 Suppl 5:24-31.

DOI: http://dx.doi.org/10.18103/imr.v6i5.904


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