Cross-System Integration of Respiration and Deglutition: Function, Treatment, and Future Directions

Martin‐Harris, Bonnie; Kantarcigil, Çagla; Reedy, Erin L.; McFarland, David H.

doi:10.1007/s00455-022-10538-x

Cited by 11 publications

(4 citation statements)

References 51 publications

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“…It aids in actions such as elevating the larynx, closing the laryngeal vestibule and vocal folds, and opening the cricopharyngeal sphincter. [29] The predominant synchronization between breathing and swallowing involved exhaling-swallowing-exhaling. Grasping the mechanisms that govern this interplay is pivotal in assessing how coordination in uences the normal swallowing process in individuals with swallowing di culties.…”

Section: Discussionmentioning

confidence: 99%

Study on predictive models for swallowing risk in patients with AECOPD

Xiong,

Zhou,

et al. 2023

Preprint

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BACKGROUND: The risk of swallowing is considered a complication in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, AECOPD may have risk factors for swallowing. METHODS: This study included 100 patients with AECOPD. General Data, lung function, COPD assessment test (CAT) and Modified Medical Research Council Dyspnea Scale (mMRC) were collected. The questionnaire survey was conducted by uniformly trained investigators using standard and neutral language, and swallowing risk was evaluated on the day of patient admission. RESULTS: Among the 100 included patients, 50(50%) were at risk of swallowing. Multivariate analysis using logistic regression analysis showed that age ≥ 74, mMRC≥2, hospitalization days≥7and the use of BIPAP assisted ventilation were important influencing factors for swallowing risk in patients with AECOPD. CONCLUSION: Patients with AECOPD are at risk for swallowing, assessing age, mMRC, hospitalization days, and the use of BIPAP assisted ventilation can be used to screen for swallowing risk, thus contributing to the implementation of early prevention measures.

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Section: Discussionmentioning

confidence: 99%

Study on predictive models for swallowing risk in patients with AECOPD

Xiong,

Zhou,

et al. 2023

Preprint

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“…A safe and efficient swallow requires coordination of the oropharyngeal muscles, cranial nerves, cerebral cortex, medulla oblongata and the muscles of respiration 9 , 10 . Swallowing is a synergistic process, requiring the precise timing of biomechanical movements as food or fluid transfer from the oral cavity through the pharynx to the oesophagus 11 , 12 . The sequence of normal swallowing is preceded by contraction of the oral and suprahyoid musculature, followed by the contraction of the pharyngeal constrictor muscles and the relaxation of the cricopharyngeal muscles 13 .…”

Section: Introductionmentioning

confidence: 99%

Assessing the oral and suprahyoid muscles in healthy adults using muscle ultrasound to inform the swallowing process: a proof-of-concept study

Kelly,

Nazeer,

Fazzini

et al. 2024

Sci Rep

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The oral and suprahyoid muscles are responsible for movements of swallowing. Our study aimed to determine the reproducibility of static and dynamic measurements of these muscles using bedside ultrasound equipment. Forty healthy participants were recruited prospectively. Primary outcomes were evaluation of mass measurements of the anterior bellies of the digastric, mylohyoid, geniohyoid and tongue in B-mode ultrasound. Secondary outcomes were evaluation of geniohyoid muscle layer thickness and function using M-mode. Muscle mass measurements demonstrated little within-participant variability. Coefficient of Variance (CoV) across muscles were: anterior belly digastric (5.0%), mylohyoid (8.7%), geniohyoid (5.0%) and tongue (3.2%). A relationship between sex (r2 = 0.131 p = 0.022) was demonstrated for the geniohyoid muscle, with males having higher transverse Cross Sectional Area (CSA) (14.3 ± 3.6 mm vs. 11.9 ± 2.5 mm, p = 0.002). Tongue size was correlated with weight (r2 = 0.356, p = 0.001), height (r2 = 0.156, p = 0.012) and sex (r2 = 0.196, p = 0.004). Resting thickness of the geniohyoid muscle layer changed with increasing bolus sizes (f = 3.898, p = 0.026). Velocity increased with bolus size (p = < 0.001, F = 8.974). However swallow time and slope distance did not, potentially influenced by higher coefficients of variation. Oral and suprahyoid muscle mass are easily assessed using bedside ultrasound. Ultrasound may provide new information about muscle mass and function during swallowing.

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“…The vital functions of both breathing and swallowing involve the upper airways, emphasising the critical need for coordinated interaction to protect the respiratory tract from aspiration [ 1 ]. This coordination can be impaired in individuals with respiratory diseases [ 2 , 3 ] due to changes in patients’ breathing patterns and modifications of the respiratory drive, which reduce the frequency of swallowing, shorten apnoeic periods and decrease glottis closure durations, ultimately increasing the likelihood of airway vulnerability [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of high-flow nasal therapy on swallowing function: a scoping review

Crimi,

Chiaramonte,

Vignera

et al. 2024

ERJ Open Res

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BackgroundHigh-flow nasal therapy (HFNT) is widely used in patients with respiratory failure in different clinical settings, but the effect of HFNT on respiratory-swallow coordination is unknown. Understanding this relationship is crucial, considering the necessity for patients to maintain adequate nutrition during daytime HFNT.PurposeThis scoping review aims to synthesise available data on the effects of HFNT flow rates on swallowing function and the possible risk of aspiration during treatment, focusing on knowledge and evidence gaps.MethodsPubMed, Scopus, Web of Science and Google Scholar databases were searched from inception to May 30th, 2023, for studies reporting data on swallowing assessment in healthy adults or patients with acute or chronic respiratory failure receiving HFNT. Data on study design, patients’ characteristics, and quality outcomes were extracted, and risk of bias was assessed.ResultsEight studies were included, four including cohorts of healthy volunteers (n=148) and four including patients with acute or chronic respiratory failure (n=151). Study designs, patient populations, and quality outcome measures were heterogeneous. Two studies indicated improvement, while four articles showed impairment in swallowing function during HFNT; two studies showed that patients’ overall clinical picture and underlying medical conditions influence swallowing-breathing coordination rather than HFNTperse. Risk of bias was judged low for all the included studies.ConclusionThis scoping review found limited and controversial evidence of the impact of HFNT on swallowing function. Remarkably, methods for swallowing function assessment were quite heterogeneous. Additional research is required to test the effect of HFNT on respiratory-swallowing coordination.

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Cross-System Integration of Respiration and Deglutition: Function, Treatment, and Future Directions

Cited by 11 publications

References 51 publications

Study on predictive models for swallowing risk in patients with AECOPD

Study on predictive models for swallowing risk in patients with AECOPD

Assessing the oral and suprahyoid muscles in healthy adults using muscle ultrasound to inform the swallowing process: a proof-of-concept study

Effects of high-flow nasal therapy on swallowing function: a scoping review

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