Swallow-Induced Alterations in Breathing in Normal Older People

Abstract

Respiratory parameters in 29 normal older subjects (mean age-73 years, SD = 5.7) were studied at rest, during single water swallows, and in continuous drinking. Respiration was recorded by intranasal air pressure changes and the moment of swallowing by pharyngoesophageal manometry. Compared with respiration at rest, respiratory rate increased immediately after 5 mL swallows as duration of breath cycles decreased from a mean of 3.8 s at rest to 3.5 s after swallowing (p = 0.003), but regularity of respiration was maintained. Deglutition apnea showed a trend toward increasing duration from a median of 1.06 to 1.24 s (p = 0.096) as bolus volume increased from 5 to 20 mL. Oxygen saturation levels were also compared, with a median fall of 2% during swallowing, but with larger and unexplained falls in several subjects. Direction of airflow monitoring showed 91% of single 5 mL swallows were followed by expiration, with postswallow inspiratory breaths occurring in 41% of subjects. Continuous swallowing of 100 mL of water from a cup and straw was typically performed with a pattern of multiple swallows per breath, with expiration occurring after 78.5% (cup) and 63.5% (straw) of swallows. This definition of swallowing-induced respiratory changes in normal older people forms a valuable basis for future comparison with elderly dysphagic patients.

Effects of Age, Gender, Bolus Volume, Bolus Viscosity, and Gustation on Swallowing Apnea Onset Relative to Lingual Bolus Propulsion Onset in Normal Adults

“…Earlier SA onset likely contributes to the increased SA duration with increased bolus SA ONSET 14 volumes reported in previous research. It should be noted that while some research has reported that SA duration increased as a function of bolus volume (Issa & Porostocky, 1994;Preiksaitis & Mills, 1996;Hiss et al, 2001;Hirst, Ford, Gibson, & Wilson, 2002), other research has reported that SA duration was not influenced by bolus volume (Preiksaitis, Mayrand, Robbins, & Diamant, 1992;Martin, Logemann, Shaker, & Dodds, 1994). The most recent studies investigating SA duration that have employed a larger number of participants, advanced technology, and normal eating/drinking simulation coupled with the findings of the current study (i.e., onset of SA started earlier with increases in bolus volume) provide strong evidence that SA duration does increase with increases in bolus volume.…”

Temporal coordination of pharyngeal and laryngeal dynamics with breathing during swallowing: single liquid swallows

“…Examples include surface electromyography or other physiological tracings (4,5,9,17,21,25,26,31,34). Although the indirect measures of swallowing are generally less invasive and permit the acquisition of greater numbers of swallowing samples, their clinical utility is suspect without simultaneous direct visual confirmation of the swallowing mechanics occurring with respiratory activity.…”

Towards microprocessor-based control of droplet parameters for endoscopic laryngeal adductor reflex triggering

“…This approach allows calculating average droplet velocities between several positions along the vertical droplet trajectory according to eq. (2): (2) where ∆y is the distance covered by the drop between two light barriers and ∆t the time of flight between those positions. Figure 4 shows the measurement setup with the highlighted measuring section ∆y = 100 mm.…”

“…Correspondingly, pneumonia is among the top ten causes of death in the elderly in the United States (age > 65) [1]. In healthy individuals, several mechanisms prevent irruption of particles into the subglottic space, the trachea and deeper airways [2]. One key mechanism is the fast, reflexive closing of the vocal folds following appropriate stimulation of the glottal mucosa, known as the Laryngeal Adductor Reflex (LAR).…”