Rose Centre for Stroke Recovery and Research, University of Canterbury, Christchurch, New Zealand.
Exp Physiol. 2024 Nov;109(11):1955-1966. doi: 10.1113/EP092025. Epub 2024 Sep 12.
Respiratory-swallowing coordination (RSC) is well established as an essential airway-protective mechanism. Previous studies have used nasal airflow and/or kinematic rib cage and abdominal measures to assess respiration surrounding swallowing, meaning that the direct influence of oral respiration on RSC remains unknown. This study used a partitioned oronasal facemask to compare respiratory phase patterns measured using isolated nasal airflow with those measured using combined oronasal airflow during non-ingestive and ingestive swallowing tasks. Twenty-four healthy individuals with no respiratory or swallowing disorders were assessed at rest and during cued dry, 10 mL water, continuous drinking and cracker swallowing tasks. Respiratory phase patterns were determined for discrete swallows using the nasal and combined oronasal channels separately. There was variable agreement between respiratory phase patterns according to the nasal and oronasal channels across swallowing conditions. The frequency of exhale-swallow-exhale, inhale-swallow-exhale and exhale-swallow-inhale patterns increased by 2%-3% each with the addition of oral flow data to nasal data, whereas the prevalence of inhale-swallow-inhale and ambiguous patterns decreased. This suggests that estimates of respiratory phase patterns are altered minimally by inclusion of oral respiratory estimates in a healthy sample. There were several additional findings of note, including lower within-participant, within-session trial consistency (test-retest reliability) than expected, suggesting high variability in respiratory phase patterns across trials. Additionally, data showed evidence of swallowing non-respiratory flow at the beginning and end of the respiratory-swallowing pause, moving in both inward and outward directions, potentially expanding current understanding of swallowing non-respiratory flow. Further in-depth physiological investigations are required to improve understanding of these findings.
呼吸-吞咽协调（RSC）是一种重要的气道保护机制，已得到广泛认可。先前的研究使用鼻气流和/或胸廓和腹部运动学测量来评估吞咽周围的呼吸，这意味着口腔呼吸对 RSC 的直接影响尚不清楚。本研究使用分区口鼻面罩，比较了在非摄食和摄食吞咽任务中，使用单独的鼻气流测量的呼吸相位模式与使用口鼻气流联合测量的呼吸相位模式。24 名无呼吸或吞咽障碍的健康个体在休息时和在提示性干吞咽、10 毫升水吞咽、连续饮水和饼干吞咽任务中接受了评估。使用单独的鼻通道和口鼻联合通道分别为离散吞咽确定呼吸相位模式。根据口鼻通道，在吞咽条件下，呼吸相位模式的一致性存在差异。随着口腔气流数据被纳入到鼻腔数据中，呼气-吞咽-呼气、吸气-吞咽-呼气和呼气-吞咽-吸气模式的频率分别增加了 2%-3%，而吸气-吞咽-吸气和模糊模式的出现率则下降。这表明，在健康样本中，包含口腔呼吸估计值对呼吸相位模式的估计值仅有微小的改变。还有一些其他值得注意的发现，包括参与者内、单次试验内（测试-重测可靠性）的一致性低于预期，这表明呼吸相位模式在试验之间存在高度的可变性。此外，数据显示在呼吸-吞咽暂停开始和结束时存在吞咽非呼吸气流的证据，这些气流朝着内外两个方向流动，这可能扩大了对吞咽非呼吸气流的当前理解。需要进一步深入的生理研究来提高对这些发现的理解。
