Boden K, Cedborg A I Hardemark, Eriksson L I, Hedström H Witt, Kuylenstierna R, Sundman E, Ekberg O
Department of Radiology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
Neurogastroenterol Motil. 2009 Nov;21(11):1163-e101. doi: 10.1111/j.1365-2982.2009.01352.x. Epub 2009 Jul 13.
The coordination of swallowing and respiration is essential for a safe swallow. Swallowing consists of several subsecond events. To study this, it is important to use modalities with high temporal resolution. In this study, we have examined young healthy individuals with simultaneous videofluoroscopy, videomanometry and respiratory recording, all with high temporal resolution. The onset of 13 predetermined swallowing and respiratory events and the surrounding respiratory phase pattern were studied in different body positions and during different respiratory drives. An increased respiratory drive was induced by breathing 5% CO(2). The results demonstrated a highly repeatable and fixed temporal coordination of the swallowing pattern despite body position and respiratory drive. Previous studies have demonstrated a period of centrally controlled apnoea during swallowing. This apnoea period has a variable length, varying from 1 to 5 s. During increased respiratory drive, we could demonstrate a significantly shorter period of apnoea during swallowing, mainly due to an earlier resumption of respiration. The high temporal recordings in this study have revealed that swallowing during expiration is present basically in all healthy individuals. This swallowing respiratory pattern seems to be appropriate for a safe swallow. This knowledge will be used as a reference for future studies on how swallowing and respiratory coordination might be altered due to ageing and diseases.
吞咽与呼吸的协调对于安全吞咽至关重要。吞咽由几个亚秒级事件组成。为了对此进行研究，使用具有高时间分辨率的方法很重要。在本研究中，我们对年轻健康个体进行了同步视频透视检查、视频测压和呼吸记录，所有这些都具有高时间分辨率。研究了13个预先确定的吞咽和呼吸事件的起始以及周围的呼吸相位模式，在不同体位和不同呼吸驱动情况下进行观察。通过呼吸5%的二氧化碳来诱导增加呼吸驱动。结果表明，尽管体位和呼吸驱动不同，吞咽模式仍具有高度可重复性和固定的时间协调性。先前的研究表明，吞咽过程中存在一段中枢控制的呼吸暂停期。这段呼吸暂停期长度可变，从1秒到5秒不等。在增加呼吸驱动时，我们能够证明吞咽期间的呼吸暂停期明显缩短，主要是由于呼吸恢复得更早。本研究中的高时间分辨率记录显示，呼气时吞咽基本上在所有健康个体中都存在。这种吞咽呼吸模式似乎有利于安全吞咽。这些知识将作为未来研究衰老和疾病如何改变吞咽与呼吸协调的参考。
