Swallowing and laryngeal complications in lung and heart transplantation: Etiologies and diagnosis

Black, Rebecca; Novakovic, Daniel; Plit, M.; Miles, Anna; Macdonald, Peter S.; Madill, Catherine

doi:10.1016/j.healun.2021.08.006

Cited by 13 publications

(22 citation statements)

References 144 publications

(208 reference statements)

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“…15,16 Suggested pathophysiological underpinnings for the high rates of oropharyngeal dysphagia after LT are vast and, at large, involve the intersection of multiple surgical, respiratory, gastroesophageal, pharmaceutical, neurological, and host-related factors. 15 The relative weight of each of these factors towards dysphagia development is unknown and confounded by conflicting evidence. 15,17 High rates of silent aspiration after LT may suggest potential afferent interruption to reflex arc circuits expected to stimulate a protective cough response.…”

Section: Introductionmentioning

confidence: 99%

“…15 The relative weight of each of these factors towards dysphagia development is unknown and confounded by conflicting evidence. 15,17 High rates of silent aspiration after LT may suggest potential afferent interruption to reflex arc circuits expected to stimulate a protective cough response. An alternative explanation, however, could be the disruption of the coordinated motor program for airway defense, whereby LT recipients are unable to adequately initiate a cough response even when appropriately evoked by activation of sensory receptors.…”

Section: Introductionmentioning

confidence: 99%

“…18,19 Indeed, pulmonary vagal denervation involved in LT procedures 20 places patients at risk for disruption to important governing neural circuitry that can adversely impact airway protection and defense. 15,21,22 Combined with the shared neuroanatomic pathways regulating breathing, swallowing, and cough, [23][24][25][26][27] it is plausible that impaired respiration and cough (dystussia) contribute to unsafe swallowing in LT recipients. Specifically, LT recipients with impaired breathing will likely exhibit difficulties with the rapid and precise reconfiguration required of respiratory and swallow subsystems to ensure safe swallowing.…”

Section: Introductionmentioning

confidence: 99%

“…Although the prevalence of oropharyngeal dysphagia and tracheal aspiration (sensate or silent) following LT procedures is high and associated with adverse outcomes, 9 underlying mechanisms that contribute to impaired airway protection during swallowing remain poorly understood. The current understanding of airway protection deficits after LT is derived from a limited number of reports and is largely informed by research in adjacent fields such as cardiothoracic surgery 15,16 . Suggested pathophysiological underpinnings for the high rates of oropharyngeal dysphagia after LT are vast and, at large, involve the intersection of multiple surgical, respiratory, gastroesophageal, pharmaceutical, neurological, and host‐related factors 15 .…”

Section: Introductionmentioning

confidence: 99%

“…The current understanding of airway protection deficits after LT is derived from a limited number of reports and is largely informed by research in adjacent fields such as cardiothoracic surgery 15,16 . Suggested pathophysiological underpinnings for the high rates of oropharyngeal dysphagia after LT are vast and, at large, involve the intersection of multiple surgical, respiratory, gastroesophageal, pharmaceutical, neurological, and host‐related factors 15 . The relative weight of each of these factors towards dysphagia development is unknown and confounded by conflicting evidence 15,17 .…”

Section: Introductionmentioning

confidence: 99%

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A prospective examination of swallow and cough dysfunction after lung transplantation

York

Croft

Anderson

et al. 2022

Neurogastroenterology Motil

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Objectives: Swallow and cough dysfunction are possible surgical complications of lung transplantation (LT). We examined voluntary cough strength, sensorimotor reflexive cough integrity, and swallow-related respiratory rate (RR) across swallowing safety and aspiration response groups in recovering LT recipients.Methods: Forty-five LT recipients underwent flexible endoscopic evaluation of swallowing indexed by the validated Penetration Aspiration Scale. RR before and after a 3-ounce water drinking task was measured. Voluntary and reflexive cough screening were performed to index motor and sensory outcomes. T-tests, one-way ANOVAs, and chi-square (odds ratios) were used.Results: 60% of patients exhibited laryngeal penetration (n = 27) and 40% demonstrated tracheal aspiration (n = 18); 72% (n = 13) demonstrated silent aspiration.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A prospective examination of swallow and cough dysfunction after lung transplantation

York

Croft

Anderson

et al. 2022

Neurogastroenterology Motil

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Effect of Food, Crushing of Tablets, and Antacid Coadministration on Maribavir Pharmacokinetics in Healthy Adult Participants: Results From 2 Phase 1, Open‐Label, Randomized, Crossover Studies

Sun,

Ilic,

et al. 2024

Clinical Pharm in Drug Dev

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The effect of food composition, tablet crushing, and antacid coadministration on maribavir pharmacokinetics was assessed in 2 Phase 1 studies in healthy adults. In the first, a single maribavir 400‐mg dose was administered under fasting conditions, with a low‐fat/low‐calorie or a high‐fat/high‐calorie meal. In the second, a single maribavir 100‐mg dose was administered under fasting conditions, as a crushed tablet, or as a whole tablet alone or with an antacid. The 90% confidence intervals of the geometric mean ratios were within 80%‐125% for area under the concentration‐time curve (AUC), but not for maximum plasma concentration (Cmax) for low‐fat/low‐calorie and high‐fat/high‐calorie meals versus fasting or for whole tablet with antacid versus whole tablet alone. The 90% confidence intervals of the geometric mean ratios for AUC and Cmax were within 80%‐125% for crushed versus whole tablet. Maribavir median time to Cmax value in plasma under fed conditions was delayed versus fasting conditions, but there was no statistical difference for crushed versus whole tablet or with versus without antacid. As the antiviral efficacy of maribavir is driven by AUC but not Cmax, findings suggest that maribavir can be administered with food or antacids or as a crushed tablet.

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A Phase 1, Open‐Label, Randomized, Two‐Part Study in Healthy Adult Volunteers to Evaluate the Bioavailability of the Maribavir Powder for Oral Suspension, as Well as Food Effect and Impact of Rabeprazole

Campagne,

Ilic,

Gabriel

et al. 2024

Clinical Pharm in Drug Dev

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The relative bioavailability and impact of food and the proton pump inhibitor rabeprazole on the pharmacokinetics of a maribavir powder‐for‐oral‐suspension formulation was investigated in a Phase 1 open‐label study in healthy adult volunteers. A single 200‐mg maribavir dose was administered as the commercial tablet (Treatment A), powder formulation (Treatment B), or powder formulation with a high‐fat/high‐calorie meal (Treatment C) in Part 1, and as the powder formulation alone (Treatment D) or following administration of rabeprazole 20 mg once daily for 5 days (Treatment E) in Part 2. Maribavir maximum plasma concentration following Treatment B was 18% lower versus Treatment A, whereas the area under the concentration‐time curve (AUC) from time 0 to the last quantifiable concentration or infinity were similar. Maribavir maximum plasma concentration, AUC from time 0 to the last quantifiable concentration, and AUC from time 0 to infinity were reduced by 42%, 18%, and 18% (Treatment C vs Treatment B), and by 51%, 30%, and 11% (Treatment E vs Treatment D), respectively. A clinically significant reduction in maribavir exposure is not expected when maribavir powder formulation is taken with food or proton pump inhibitors. Participants assessed the powder for oral suspension as easy to swallow and having an acceptable taste/texture. Safety profiles for maribavir formulations in this study were consistent with those previously published.

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Swallowing and laryngeal complications in lung and heart transplantation: Etiologies and diagnosis

Cited by 13 publications

References 144 publications

A prospective examination of swallow and cough dysfunction after lung transplantation

A prospective examination of swallow and cough dysfunction after lung transplantation

Effect of Food, Crushing of Tablets, and Antacid Coadministration on Maribavir Pharmacokinetics in Healthy Adult Participants: Results From 2 Phase 1, Open‐Label, Randomized, Crossover Studies

A Phase 1, Open‐Label, Randomized, Two‐Part Study in Healthy Adult Volunteers to Evaluate the Bioavailability of the Maribavir Powder for Oral Suspension, as Well as Food Effect and Impact of Rabeprazole

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