RATIONALE AND OBJECTIVES: The authors evaluated the coordination of swallowing and respiration in dysphagic patients. MATERIALS AND METHODS: Video fluoroscopy and respirometry were performed simultaneously during 98 swallows in 33 patients (18 women, 15 men) with a median age of 70 years (interquartile range, 52-78 years). Pharyngeal transit time, deglutition apnea, and the ratio between the two (swallowing safety index) were calculated. Presence of a misdirected swallow (aspiration or penetration) was indicated. RESULTS: Pharyngeal transit time was not associated with deglutition apnea. Misdirected swallow was associated with a slightly prolonged pharyngeal transit time, a slightly shorter deglutition apnea, and a significantly lower swallowing safety index (1.8 [1.0-4.2] vs 4.5 [2.4-6.7]; P < .001) compared with normally directed swallow. The association between misdirected swallow and lower swallowing safety index was independent of pharyngeal transit time. CONCLUSION: Assessment of respiration is important in the evaluation of dysphagia. Aspiration, especially in elderly dysphagic patients, may be a consequence of primarily disturbed respiration. A low swallowing safety index may indicate risk of misdirected swallow.
RATIONALE AND OBJECTIVES: The authors evaluated the coordination of swallowing and respiration in dysphagic patients. MATERIALS AND METHODS: Video fluoroscopy and respirometry were performed simultaneously during 98 swallows in 33 patients (18 women, 15 men) with a median age of 70 years (interquartile range, 52-78 years). Pharyngeal transit time, deglutition apnea, and the ratio between the two (swallowing safety index) were calculated. Presence of a misdirected swallow (aspiration or penetration) was indicated. RESULTS: Pharyngeal transit time was not associated with deglutition apnea. Misdirected swallow was associated with a slightly prolonged pharyngeal transit time, a slightly shorter deglutition apnea, and a significantly lower swallowing safety index (1.8 [1.0-4.2] vs 4.5 [2.4-6.7]; P < .001) compared with normally directed swallow. The association between misdirected swallow and lower swallowing safety index was independent of pharyngeal transit time. CONCLUSION: Assessment of respiration is important in the evaluation of dysphagia. Aspiration, especially in elderly dysphagic patients, may be a consequence of primarily disturbed respiration. A low swallowing safety index may indicate risk of misdirected swallow.
Authors: D H McFarland; B Martin-Harris; A-J Fortin; K Humphries; E Hill; K Armeson Journal: Respir Physiol Neurobiol Date: 2016-09-06 Impact factor: 1.931
Authors: Bonnie Martin-Harris; David McFarland; Elizabeth G Hill; Charlton B Strange; Kendrea L Focht; Zhuang Wan; Julie Blair; Katlyn McGrattan Journal: Arch Phys Med Rehabil Date: 2014-12-11 Impact factor: 3.966
Authors: Martin B Brodsky; David H McFarland; Thomas S Dozier; Julie Blair; Christopher Ayers; Yvonne Michel; M Boyd Gillespie; Terry A Day; Bonnie Martin-Harris Journal: Head Neck Date: 2010-04 Impact factor: 3.147
Authors: Roxann Diez Gross; Charles W Atwood; Sheryl B Ross; Kimberly A Eichhorn; Joan W Olszewski; Patrick J Doyle Journal: Dysphagia Date: 2007-11-20 Impact factor: 3.438