Skip to main content
Top
Published in: Clinical Oral Investigations 3/2017

01-04-2017 | Original Article

Effect of nasal high-flow oxygen therapy on the swallowing reflex: an in vivo volunteer study

Authors: Takuro Sanuki, Gaku Mishima, Kensuke Kiriishi, Toshihiro Watanabe, Ichiro Okayasu, Mari Kawai, Shinji Kurata, Takao Ayuse

Published in: Clinical Oral Investigations | Issue 3/2017

Login to get access

Abstract

Objective

The advantages of nasal high-flow oxygen therapy (NHF) include not only allowing talking, but also eating and drinking, during the therapy. However, the effect of NHF on the swallowing reflex remains unclear. In the present study, we aimed to assess the effects of NHF on the swallowing reflex.

Methods

Nine healthy adult Japanese male volunteers with no history of dysphagia or diseases that may cause dysphagia, such as stroke or Parkinson’s disease, were evaluated. Participants received one of four levels of NHF intervention (0 (control), 15, 30 and 45 L/min of oxygen) with the NHF system through the nasal cannula. Swallowing was induced by the administration of a bolus injection of 5 mL of distilled water over 3 s through a polyethylene catheter at each level of oxygen flow. The primary end-point was the latency period of the swallowing reflex after bolus injection, which was defined as the time from the start of the bolus injection to the onset of the electromyogram (EMG) burst of the first swallow.

Results

Mean latency times of the swallowing reflex with 15 (9.8 ± 2.9 s), 30 (9.0 ± 2.7 s) and 45 (8.5 ± 3.0 s) L/min of NHF were significantly shorter than those under control conditions (11.9 ± 3.7 s; P < 0.05).

Conclusions

Our study demonstrates that NHF may enhance swallowing function with increasing levels of NHF by reducing the latency of the reflex.

Clinical relevance

NHF may allow continuation of oral intake without aspiration during oxygen therapy.
Literature
1.
go back to reference Gotera C, Díaz Lobato S, Pinto T, Winck JC (2013) Clinical evidence on high flow oxygen therapy and active humidification in adults. Rev Port Pneumol 19:217–227CrossRefPubMed Gotera C, Díaz Lobato S, Pinto T, Winck JC (2013) Clinical evidence on high flow oxygen therapy and active humidification in adults. Rev Port Pneumol 19:217–227CrossRefPubMed
2.
go back to reference Powell NB, Riley RW, Guilleminault C, Murcia GN (1988) Obstructive sleep apnea, continuous positive airway pressure, and surgery. Otolaryngol Head Neck Surg 99:362–369CrossRefPubMed Powell NB, Riley RW, Guilleminault C, Murcia GN (1988) Obstructive sleep apnea, continuous positive airway pressure, and surgery. Otolaryngol Head Neck Surg 99:362–369CrossRefPubMed
3.
go back to reference Rennotte MT, Baele P, Aubert G, Rodenstein DO (1995) Nasal continuous positive airway pressure in the perioperative management of patients with obstructive sleep apnea submitted to surgery. Chest 107:367–374CrossRefPubMed Rennotte MT, Baele P, Aubert G, Rodenstein DO (1995) Nasal continuous positive airway pressure in the perioperative management of patients with obstructive sleep apnea submitted to surgery. Chest 107:367–374CrossRefPubMed
4.
go back to reference Manley BJ, Owen LS, Doyle LW, Andersen CC, Cartwright DW, Pritchard MA, Donath SM, Davis PG (2013) High-flow nasal cannulae in very preterm infants after extubation. N Engl J Med 369:1425–1433CrossRefPubMed Manley BJ, Owen LS, Doyle LW, Andersen CC, Cartwright DW, Pritchard MA, Donath SM, Davis PG (2013) High-flow nasal cannulae in very preterm infants after extubation. N Engl J Med 369:1425–1433CrossRefPubMed
6.
go back to reference Mündel T, Feng S, Tatkov S, Schneider H (2013) Mechanisms of nasal high flow on ventilation during wakefulness and sleep. J Appl Physiol (1985) 114:1058–1065CrossRefPubMedPubMedCentral Mündel T, Feng S, Tatkov S, Schneider H (2013) Mechanisms of nasal high flow on ventilation during wakefulness and sleep. J Appl Physiol (1985) 114:1058–1065CrossRefPubMedPubMedCentral
7.
go back to reference Nishino T, Sugimori K, Kohchi A, Hiraga K (1989) Nasal constant positive airway pressure inhibits the swallowing reflex. Am Rev Respir Dis 140:1290–1293CrossRefPubMed Nishino T, Sugimori K, Kohchi A, Hiraga K (1989) Nasal constant positive airway pressure inhibits the swallowing reflex. Am Rev Respir Dis 140:1290–1293CrossRefPubMed
9.
go back to reference Groves N, Tobin A (2007) High flow nasal oxygen generates positive airway pressure in adult volunteers. Aust Crit Care 20:126–131CrossRefPubMed Groves N, Tobin A (2007) High flow nasal oxygen generates positive airway pressure in adult volunteers. Aust Crit Care 20:126–131CrossRefPubMed
10.
go back to reference Samson N, Roy B, Ouimet A, Moreau-Bussière F, Dorion D, Mayer S, Praud JP (2008) Origins of the inhibiting effects of nasal CPAP on nonnutritive swallowing in newborn lambs. J Appl Physiol 105:1083–1090CrossRefPubMed Samson N, Roy B, Ouimet A, Moreau-Bussière F, Dorion D, Mayer S, Praud JP (2008) Origins of the inhibiting effects of nasal CPAP on nonnutritive swallowing in newborn lambs. J Appl Physiol 105:1083–1090CrossRefPubMed
11.
go back to reference Nishino T, Hasegawa R, Ide T, Isono S (1998) Hypercapnia enhances the development of coughing during continuous infusion of water into the pharynx. Am J Respir Crit Care Med 157:815–821CrossRefPubMed Nishino T, Hasegawa R, Ide T, Isono S (1998) Hypercapnia enhances the development of coughing during continuous infusion of water into the pharynx. Am J Respir Crit Care Med 157:815–821CrossRefPubMed
12.
go back to reference Nishino T (1993) Swallowing as a protective reflex for the upper respiratory tract. Anesthesiology 79:588–601CrossRefPubMed Nishino T (1993) Swallowing as a protective reflex for the upper respiratory tract. Anesthesiology 79:588–601CrossRefPubMed
13.
go back to reference Corley A, Caruana LR, Barnett AG, Tronstad O, Fraser JF (2011) Oxygen delivery through high-flow nasal cannulae increase end-expiratory lung volume and reduce respiratory rate in post-cardiac surgical patients. Br J Anaesth 107:998–1004CrossRefPubMed Corley A, Caruana LR, Barnett AG, Tronstad O, Fraser JF (2011) Oxygen delivery through high-flow nasal cannulae increase end-expiratory lung volume and reduce respiratory rate in post-cardiac surgical patients. Br J Anaesth 107:998–1004CrossRefPubMed
14.
go back to reference Frizzola M, Miller TL, Rodriguez ME, Zhu Y, Rojas J, Hesek A, Stump A, Shaffer TH, Dysart K (2011) High-flow nasal cannula: impact on oxygenation and ventilation in an acute lung injury model. Pediatr Pulmonol 46:67–74CrossRefPubMed Frizzola M, Miller TL, Rodriguez ME, Zhu Y, Rojas J, Hesek A, Stump A, Shaffer TH, Dysart K (2011) High-flow nasal cannula: impact on oxygenation and ventilation in an acute lung injury model. Pediatr Pulmonol 46:67–74CrossRefPubMed
15.
go back to reference Bräunlich J, Beyer D, Mai D, Hammerschmidt S, Seyfarth HJ, Wirtz H (2013) Effects of nasal high flow on ventilation in volunteers, COPD and idiopathic pulmonary fibrosis patients. Respiration 85:319–325CrossRefPubMed Bräunlich J, Beyer D, Mai D, Hammerschmidt S, Seyfarth HJ, Wirtz H (2013) Effects of nasal high flow on ventilation in volunteers, COPD and idiopathic pulmonary fibrosis patients. Respiration 85:319–325CrossRefPubMed
Metadata
Title
Effect of nasal high-flow oxygen therapy on the swallowing reflex: an in vivo volunteer study
Authors
Takuro Sanuki
Gaku Mishima
Kensuke Kiriishi
Toshihiro Watanabe
Ichiro Okayasu
Mari Kawai
Shinji Kurata
Takao Ayuse
Publication date
01-04-2017
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 3/2017
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-016-1822-3

Other articles of this Issue 3/2017

Clinical Oral Investigations 3/2017 Go to the issue