Maturation Modulates Pharyngeal-Stimulus Provoked Pharyngeal and Respiratory Rhythms in Human Infants

• Published in: Dysphagia 2018-02, Vol.33 (1), p.63-75
• Main Authors: Hasenstab, Kathryn A., Sitaram, Swetha, Lang, Ivan M., Shaker, Reza, Jadcherla, Sudarshan R.
• Format: Article
• Language: English
• Subjects: Analysis; Apnea; Deglutition - physiology; Esophagus; Esophagus - physiology; Female; Gastroenterology; Gastroesophageal reflux; Hepatology; Humans; Imaging; Infant; Infant, Extremely Premature - physiology; Infant, Newborn; Infants; Infants (Premature); Male; Manometry; Medicine; Medicine & Public Health; Neonatology; Noninvasive Ventilation; Original Article; Otorhinolaryngology; Pharynx; Pharynx - physiology; Plethysmography; Radiology; Respiration; Respiratory tract; Swallowing; Temperature measurements
• ISSN: 0179-051X; 1432-0460
• DOI: 10.1007/s00455-017-9833-z

Pharyngeal-provocation induced aerodigestive symptoms in infants remain an enigma. Sources of pharyngeal provocation can be anterograde as with feeding, and retrograde as in gastroesophageal reflux. We determined maturational and dose–response effects of targeted pharyngeal-stimulus on frequency, stability, and magnitude of pharyngeal and respiratory waveforms during multiple pharyngeal swallowing responses in preterm-born infants when they were of full-term postmenstrual age (PMA). Eighteen infants (11 male) were studied longitudinally at 39.8 ± 4.8 weeks PMA (time-1) and 44.1 ± 5.8 weeks PMA (time-2). Infants underwent concurrent pharyngo-esophageal manometry, respiratory inductance plethysmography, and nasal airflow thermistor methods to test sensory-motor interactions between the pharynx, esophagus, and airway. Linear mixed models were used and data presented as mean ± SEM or %. Overall, responses to 250 stimuli were analyzed. Of the multiple pharyngeal swallowing responses ( n  = 160), with maturation (a) deglutition apnea duration decreases ( p