Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany, Moorenstrasse 5, 40225, Düsseldorf, Germany.
TU Berlin, Control Systems Group, Einsteinufer 17, 10587, Berlin, Germany.
Eur Arch Otorhinolaryngol. 2024 Feb;281(2):843-854. doi: 10.1007/s00405-023-08344-8. Epub 2023 Nov 24.
Preterm infants (PI) have difficulty coordinating sucking, swallowing and breathing, and there is a risk of aspiration. The causes of this are not yet sufficiently understood. The aim of this study was to test a novel measurement device to measure breathing and pharyngeal processes involved in swallowing externally in everyday life to identify possible differences in neonates (NB) and PI.
Forty healthy NB were studied at 4-8 weeks of age (mean: 6.7 weeks) and 20 healthy PI (mean gestational age 30.5 weeks) at postmenstrual age (PMA) 34/35 weeks (mean PMA 35.1 weeks) during a single feeding. Surface electrodes were used to measure bioimpedance and electromyography reflecting swallow-related changes in the pharynx and muscle activation of the tongue and submental muscles. A respiratory belt was combined with recording of the depth of chest movements and the occurrence of pauses in breathing.
Velocity and extent of pharyngeal closure did not differ significantly across the feeding period (velocity: p=0.09, closure: p=0.17), but during the first two suck-swallow bursts PI had greater velocity (p<0.001*) and extent of pharyngeal closure (p=0.004*) than NB. The duration of swallowing phases was significantly longer in PIs (p<0.001*), their muscle activation decreased faster (p<0.001*), and they had more pauses in breathing than NBs.
The novel measurement device allowed, for the first time in everyday life, the measurement of factors influencing swallowing and breath-swallow coordination in NBs and PIs. PIs showed differences from NBs most likely due to differences in muscle strength and condition.
早产儿（PI）在协调吸吮、吞咽和呼吸方面存在困难，存在吸入风险。其原因尚不完全清楚。本研究旨在测试一种新的测量设备，以测量日常生活中与吞咽相关的呼吸和咽部过程，以确定新生儿（NB）和 PI 之间可能存在的差异。
40 名健康 NB 在 4-8 周龄（平均：6.7 周）和 20 名健康 PI（平均胎龄 30.5 周）在出生后 34/35 周（平均胎龄 35.1 周）期间进行单次喂养时进行研究。使用表面电极测量生物阻抗和肌电图，反映与吞咽相关的咽部变化以及舌和颏下肌肉的肌肉激活。呼吸带与记录胸部运动深度和呼吸暂停的发生相结合。
在喂养期间，咽闭合的速度和程度没有显著差异（速度：p=0.09，闭合：p=0.17），但在最初的两个吸吮-吞咽爆发期间，PI 的速度（p<0.001*）和咽闭合的程度（p=0.004*）明显大于 NB。PI 吞咽阶段的持续时间明显更长（p<0.001*），其肌肉激活下降更快（p<0.001*），并且呼吸暂停次数多于 NB。
该新型测量设备首次允许在日常生活中测量影响 NB 和 PI 吞咽和呼吸吞咽协调的因素。PI 与 NB 之间的差异很可能是由于肌肉力量和状况的差异造成的。
