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Published in: Lung 5/2018

01-10-2018 | RESPIRATORY PHYSIOLOGY

Strategies for the Integration of Cough and Swallow to Maintain Airway Protection in Humans

Authors: Alyssa Huff, Mitchell D. Reed, Barbara K. Smith, Edward H. Brown Jr., Alexander V. Ovechkin, Teresa Pitts

Published in: Lung | Issue 5/2018

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Abstract

Purpose

Airway protective behaviors, like cough and swallow, deteriorate in many populations suffering from neurologic disorders. While coordination of these behaviors has been investigated in an animal model, it has not been tested in humans.

Methods

We used a novel protocol, adapted from previous work in the cat, to assess cough and swallow independently and their coordination strategies in seven healthy males (26 ± 6 years). Surface electromyograms of the submental complex and external oblique complex, spirometry, and thoracic and abdominal wall kinematics, were used to evaluate the timing of swallow, cough, and breathing as well as lung volume (LV) during these behaviors.

Results

Unlike the cat, there was significant variability in the cough-swallow phase preference; however, there was a targeted LV range in which swallow occurred.

Conclusion

These results give insight into the differences between the cat and human models in airway protective strategies related to the coordination of cough and swallow behaviors, allowing for better understanding of dystussia and dysphagia.
Literature
1.
go back to reference Bolser DC, Gestreau C, Morris KF, Davenport PW, Pitts TE (2013) Central neural circuits for coordination of swallowing, breathing, and coughing: predictions from computational modeling and simulation. Otolaryngol Clin North Am 46(6):957–964CrossRefPubMed Bolser DC, Gestreau C, Morris KF, Davenport PW, Pitts TE (2013) Central neural circuits for coordination of swallowing, breathing, and coughing: predictions from computational modeling and simulation. Otolaryngol Clin North Am 46(6):957–964CrossRefPubMed
2.
go back to reference Pitts T, Morris K, Lindsey B, Davenport P, Poliacek I, Bolser D (2012) Co-ordination of cough and swallow in vivo and in silico. Exp Physiol 97(4):469–473CrossRefPubMed Pitts T, Morris K, Lindsey B, Davenport P, Poliacek I, Bolser D (2012) Co-ordination of cough and swallow in vivo and in silico. Exp Physiol 97(4):469–473CrossRefPubMed
3.
go back to reference Pitts T, Rose MJ, Mortensen AN, Poliaček I, Sapienza CM, Lindsey BG, Morris KF, Davenport PW, Bolser DC (2013) Coordination of cough and swallow: a meta-behavioral response to aspiration. Respir Physiol Neurobiol 189(3):543–551CrossRefPubMed Pitts T, Rose MJ, Mortensen AN, Poliaček I, Sapienza CM, Lindsey BG, Morris KF, Davenport PW, Bolser DC (2013) Coordination of cough and swallow: a meta-behavioral response to aspiration. Respir Physiol Neurobiol 189(3):543–551CrossRefPubMed
5.
go back to reference Smith Hammond CA, Goldstein LB, Zajac DJ, Gray L, Davenport PW, Bolser DC (2001) Assessment of aspiration risk in stroke patients with quantification of voluntary cough. Neurology 56(4):502–506CrossRefPubMed Smith Hammond CA, Goldstein LB, Zajac DJ, Gray L, Davenport PW, Bolser DC (2001) Assessment of aspiration risk in stroke patients with quantification of voluntary cough. Neurology 56(4):502–506CrossRefPubMed
6.
9.
go back to reference Cook IJ, Dodds WJ, Dantas RO, Kern MK, Massey BT, Shaker R, Hogan WJ (1989) Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing. Dysphagia 4(1):8–15CrossRefPubMed Cook IJ, Dodds WJ, Dantas RO, Kern MK, Massey BT, Shaker R, Hogan WJ (1989) Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing. Dysphagia 4(1):8–15CrossRefPubMed
10.
go back to reference Shaker R, Dodds WJ, Dantas RO, Hogan WJ, Arndorfer RC (1990) Coordination of deglutitive glottic closure with oropharyngeal swallowing. Gastroenterology 98(6):1478–1484CrossRefPubMed Shaker R, Dodds WJ, Dantas RO, Hogan WJ, Arndorfer RC (1990) Coordination of deglutitive glottic closure with oropharyngeal swallowing. Gastroenterology 98(6):1478–1484CrossRefPubMed
12.
go back to reference Konno K, Mead J (1967) Measurement of the separate volume changes of rib cage and abdomen during breathing. J Appl Physiol 22(3):407–422CrossRefPubMed Konno K, Mead J (1967) Measurement of the separate volume changes of rib cage and abdomen during breathing. J Appl Physiol 22(3):407–422CrossRefPubMed
22.
go back to reference Coleridge HM JCGC (1986) Reflexes evoked from the tracheobronchial tree and lungs. In: Fishman AP (ed) Handbook of physiology: the respiratory system; control of breathing, vol II. American Physiology Society, Bethesda, pp 395–429 Coleridge HM JCGC (1986) Reflexes evoked from the tracheobronchial tree and lungs. In: Fishman AP (ed) Handbook of physiology: the respiratory system; control of breathing, vol II. American Physiology Society, Bethesda, pp 395–429
24.
go back to reference Bradley GW, von Euler C, Marttila I, Roos B (1975) A model of the central and reflex inhibition of inspiration in the cat. Biol Cybern 19(2):105–116CrossRefPubMed Bradley GW, von Euler C, Marttila I, Roos B (1975) A model of the central and reflex inhibition of inspiration in the cat. Biol Cybern 19(2):105–116CrossRefPubMed
25.
go back to reference Agostoni EDA E (1975) Tonic vagal influences on inspiratory duration. Respir Physiol 24(3):287–302CrossRefPubMed Agostoni EDA E (1975) Tonic vagal influences on inspiratory duration. Respir Physiol 24(3):287–302CrossRefPubMed
26.
go back to reference Karczewski W (1962) Effects of afferent vagal activity recorded on magnetic tape on the respiration of vagotomised animals. Bull Pol Acad Sci (10):499–500 Karczewski W (1962) Effects of afferent vagal activity recorded on magnetic tape on the respiration of vagotomised animals. Bull Pol Acad Sci (10):499–500
27.
go back to reference Widdicombe JG (1964) Respiratory reflexes. In: Fenn WO, Rahn R (eds) Handbook of physiology: section 3. Respiration, vol I. American Physiological Society, Washington, DC, pp 585–630 Widdicombe JG (1964) Respiratory reflexes. In: Fenn WO, Rahn R (eds) Handbook of physiology: section 3. Respiration, vol I. American Physiological Society, Washington, DC, pp 585–630
28.
go back to reference Trenchard D (1977) Role of pulmonary stretch receptors during breathing in rabbits, cats and dogs. Respir Physiol 29(2):231–246CrossRefPubMed Trenchard D (1977) Role of pulmonary stretch receptors during breathing in rabbits, cats and dogs. Respir Physiol 29(2):231–246CrossRefPubMed
29.
go back to reference Hanacek J, Davies A, Widdicombe JG (1984) Influence of lung stretch receptors on the cough reflex in rabbits. Respiration 45(3):161–168CrossRefPubMed Hanacek J, Davies A, Widdicombe JG (1984) Influence of lung stretch receptors on the cough reflex in rabbits. Respiration 45(3):161–168CrossRefPubMed
30.
go back to reference Bucher K (1958) Pathophysiology and pharmacology of cough. Pharmacol Rev 10(1):43–58PubMed Bucher K (1958) Pathophysiology and pharmacology of cough. Pharmacol Rev 10(1):43–58PubMed
31.
go back to reference Sant’Ambrogio G, Sant’Ambrogio FB, Davies A (1984) Airway receptors in cough. Bull Eur Physiopathol Respir 20(1):43–47PubMed Sant’Ambrogio G, Sant’Ambrogio FB, Davies A (1984) Airway receptors in cough. Bull Eur Physiopathol Respir 20(1):43–47PubMed
33.
go back to reference Askanazi J, Silverberg PA, Foster RJ, Hyman AI, Milic-Emili J, Kinney JM (1980) Effects of respiratory apparatus on breathing pattern. J Appl Physiol 48(4):577–580CrossRefPubMed Askanazi J, Silverberg PA, Foster RJ, Hyman AI, Milic-Emili J, Kinney JM (1980) Effects of respiratory apparatus on breathing pattern. J Appl Physiol 48(4):577–580CrossRefPubMed
34.
go back to reference Wohlgemuth M, van der Kooi EL, Hendriks JC, Padberg GW, Folgering HT (2003) Face mask spirometry and respiratory pressures in normal subjects. Eur Respir J 22(6):1001–1006CrossRefPubMed Wohlgemuth M, van der Kooi EL, Hendriks JC, Padberg GW, Folgering HT (2003) Face mask spirometry and respiratory pressures in normal subjects. Eur Respir J 22(6):1001–1006CrossRefPubMed
36.
go back to reference Clark GA (1920) Deglutition apnoea. J Physiol 54:59 Clark GA (1920) Deglutition apnoea. J Physiol 54:59
39.
go back to reference Martin BJ, Logemann JA, Shaker R, Dodds WJ (1994) Coordination between respiration and swallowing: respiratory phase relationships and temporal integration. J Appl Physiol 76 (2):714–723CrossRefPubMed Martin BJ, Logemann JA, Shaker R, Dodds WJ (1994) Coordination between respiration and swallowing: respiratory phase relationships and temporal integration. J Appl Physiol 76 (2):714–723CrossRefPubMed
41.
go back to reference Hiss SG, Treole K, Stuart A (2001) Effects of age, gender, bolus volume, and trial on swallowing apnea duration and swallow/respiratory phase relationships of normal adults. Dysphagia 16(2):128–135CrossRefPubMed Hiss SG, Treole K, Stuart A (2001) Effects of age, gender, bolus volume, and trial on swallowing apnea duration and swallow/respiratory phase relationships of normal adults. Dysphagia 16(2):128–135CrossRefPubMed
Metadata
Title
Strategies for the Integration of Cough and Swallow to Maintain Airway Protection in Humans
Authors
Alyssa Huff
Mitchell D. Reed
Barbara K. Smith
Edward H. Brown Jr.
Alexander V. Ovechkin
Teresa Pitts
Publication date
01-10-2018
Publisher
Springer US
Published in
Lung / Issue 5/2018
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-018-0133-7

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