Gastroenterology Unit, Child, Youth & Women's Health Service, North Adelaide, SA, Australia.
Neurogastroenterol Motil. 2011 Jun;23(6):551-e206. doi: 10.1111/j.1365-2982.2010.01634.x. Epub 2010 Dec 10.
The role of pharyngeal impedance recording for assessing pharyngeal function is yet to be established. The aim of this study was to evaluate impedance flow interval, a novel parameter, in relation to bolus residue and the occurrence of aspiration. The effect of catheter configuration was also assessed.
We studied 12 children (1.8-13.5years) with cerebral palsy, who were all referred for a videofluoroscopy due to suspected aspiration risk. Pharyngeal impedance patterns during bolus swallowing were recorded simultaneously with fluoroscopy. Two different catheter configurations were used: Catheter 1, 1.9mm diameter with 1cm electrodes and Catheter 2, 3.2mm diameter with 2cm electrodes. The flow interval was based on the objective assessment of impedance drop and recovery across multiple impedance segments and was correlated with fluoroscopic evidence of postswallow bolus residue and deglutitive aspiration.
One hundred and thirty two liquid swallows were evaluated. Patient swallows with aspiration compared to those without aspiration had a longer flow interval (Cath 1 P=0.005; Cath 2 P<0.001). Patient swallows with residue had a longer flow interval, however this was only significant for swallows recorded using Catheter 2 (P=0.004). Multiple logistic regressions showed that higher flow interval was a better marker of the presence of aspiration [odds ratio (OR) 13.4 (3.0, 59.2); P<0.001] than the presence of residue [OR 3.8 (1.4, 10.3); P=0.01].
CONCLUSIONS & INFERENCES: We present novel findings suggesting that impedance measurement can detect alterations in flow characteristics of pharyngeal swallow that have the potential to predict to deglutitive aspiration risk.
咽阻抗记录在评估咽功能中的作用尚未确定。本研究旨在评估一种新的参数——阻抗流间隔，与食团残留和误吸的发生的关系。还评估了导管构型的影响。
我们研究了 12 名脑瘫儿童（1.8-13.5 岁），他们均因疑似误吸风险而接受荧光透视检查。在吞咽时同步记录咽阻抗模式。使用两种不同的导管构型：导管 1，直径 1.9mm，带有 1cm 的电极和导管 2，直径 3.2mm，带有 2cm 的电极。流间隔基于阻抗下降和恢复的客观评估，跨越多个阻抗段，并与吞咽后食团残留和吞咽时误吸的荧光透视证据相关联。
评估了 132 次液体吞咽。与无误吸的吞咽相比，有吞咽误吸的患者的流间隔更长（导管 1，P=0.005；导管 2，P<0.001）。有食团残留的患者的流间隔更长，但这仅在使用导管 2 记录的吞咽中具有统计学意义（P=0.004）。多元逻辑回归显示，较高的流间隔是存在误吸的更好标志物[比值比（OR）13.4（3.0，59.2）；P<0.001]，而不是存在残留的标志物[OR 3.8（1.4，10.3）；P=0.01]。
我们提出了新的发现，表明阻抗测量可以检测到咽吞咽的流特征的改变，这些改变有可能预测吞咽时的误吸风险。
