Effect of Laparotomy on the Swallow–Breathing Relationship in the Cat

Abstract

Swallow occurs predominantly in the expiratory phase (E) of breathing. This phase preference is thought to contribute to airway protection by limiting the passage of material through the pharyngeal airway with little or no inspiratory (I) airflow. This phase preference is attributed to central interactions between the swallow and breathing pattern generators. We speculated that changes in peripheral mechanical factors would influence the respiratory phase preference for swallow initiation. We induced swallowing in anesthetized spontaneously breathing cats by injection of water into the oropharynx. In animals with intact abdomens, 83% of swallows were initiated during E, 7% during I, 7% during E-I phase transition and 3% during I-E transition. In animals with open anterior midline laparotomy, only 38% of swallows were initiated during E, 33% during I, 17% during the E-I transition, and 12% during I-E. The results support an important role for feedback from somatic and/or visceral thoraco-abdominal mechanoreceptors for swallow-breathing coordination after laparotomy.

Respiratory motor training and neuromuscular plasticity in patients with chronic obstructive pulmonary disease: A pilot study

“…It has been demonstrated clinically however, that patients with COPD switch from swallowing during expiration to inspiration (Leslie et al, 2002; Selley et al, 1989). It is not fully understood why this occurs, however it has been hypothesized by Pitts et al (2015) that alterations in biomechanics and thoracic-abdominal somatic and/or visceral mechanoreceptors lead changes in the central pattern generators (Pitts et al, 2015). This current work provides additional evidence that maladaptive neuromuscular changes from COPD could also be a potential mechanism.…”

Coordination of airway protective behaviors and swallow: effects of afferent feedback and sex.

“…Then the following assigned coding system was used with In-Ex = 1; Ex-Ex = 2; Ex-In = 3; and In-In = 4 to categorize where each swallow occurred (Table 3-1). Finally, Wilcoxon signed ranks tests were run to determine changes across swallowtype and altitude, as we have previously used (Pitts, Rose, Poliacek, Condrey, Davenport, & Bolser, 2015).…”

“…Swallow phase preference has been intensely studied in humans (Martin-Harris, 2008;Martin-Harris, Brodsky, Michel, Castell, Schleicher, Sandidge, Maxwell, & Blair, 2008;Martin-Harris, Brodsky, Price, Michel, & Walters, 2003b;Martin-Harris & McFarland, 2013;Pratali, Cavana, Sicari, & Picano, 2010;Wheeler Hegland, Huber, Pitts, Davenport, & Sapienza, 2011a;Wheeler Hegland, Huber, Pitts, & Sapienza, 2009a), as well as in cats (Dick, Oku, Romaniuk, & Cherniack, 1993a;Pitts, Gayagoy, Rose, Poliacek, Condrey, Musslewhite, Shen, Davenport, & Bolser, 2015a;Pitts, Rose, Mortensen, Poliacek, Sapienza, Lindsey, Morris, Davenport, & Bolser, 2013a;Pitts, Rose, Poliacek, Condrey, Davenport, & Bolser, 2015), goats (Bonis, Neumueller, Marshall, Krause, Qian, Pan, Hodges, & Forster, 2011a;Feroah, Forster, Fuentes, Wenninger, Martino, Hodges, Pan, & Rice, 2002), and rats (Saito, Ezure, & Tanaka, 2002a, 2002b. However, all the peripheral stimulations and/or central mechanisms which regulate their interactions are not entirely understood.…”

“…The central mechanism is thought to be due to interactions of breathing and swallow pattern generators (Dick, Oku, Romaniuk, & Cherniack, 1993a;Miller, 1982b), however this preference can be modified by peripheral feedback (Pitts, Condrey, Davenport, & Bolser, 2015) and disease (Brodsky, McFarland, Dozier, Blair, Ayers, Michel, Gillespie, Day, & Martin-Harris, 2010;Leslie, Drinnan, Ford, & Wilson, 2002;Troche, Huebner, Rosenbek, Okun, & Sapienza, 2011). Specifically, alterations in respiratory mechanics due to chronic obstructive pulmonary disease (Nagami, Oku, Yagi, Sato, Uozumi, Morita, Yamagata, Kayashita, Tanimura, Sato, Takahashi, & Muro, 2017;Pinto, Balasubramanium, & Acharya, 2017) and/or upper abdominal laparotomy can shift swallow occurrences to inspiration, potentially increasing risk of aspiration (Pitts, Rose, Poliacek, Condrey, Davenport, & Bolser, 2015). Additionally, there is also limited evidence that alterations in blood gasses (i.e., oxygen [O2] and carbon dioxide [CO2]) can also increase the likelihood that swallow will occur during inspiration (D'Angelo, Diaz-Gil, Nunn, Simons, Gianatasio, Mueller, Meyer, Pierce, Rosow, & Eikermann, 2014), (Ghannouchi, Duclos, Marie, & Verin, 2013).…”

Swallow and breathing coordination following suprahyoid muscle injury.

“…Analyzing fluctuating burst onsets of the MyHy can help distinguish pharyngeal swallows from sucking, licking, and lapping (Kaplan & Grill, 1989;Naganuma, Inoue, Yamamura, Hanada, & Yamada, 2001;van Eijden & Koolstra, 1998), as MyHy EMG activity shows bursts during these actions while the hyoglossus, stylohyoid, or thyrohyoid (ThHy) EMGs readings do not ). As such, numerous studies have used the onset of MyHy activity to denote the initiation of pharyngeal swallowing behavior (Holman et al, 2014;Holman et al, 2013;Kajii et al, 2002;Pitts et al, 2015;Thexton, Crompton, & German, 2012).…”