In the first issue for April of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine, Roxann Diez Gross, Ph.D., and colleagues report that patients with moderate to severe COPD exhibit alterations between breathing and swallowing patterns even when they are not experiencing exacerbations.
While it was previously known that COPD patients exhibited decoupling of the breathing-swallowing pattern of saliva during exacerbations, until now there were no formal studies detailing to what extent, if any, disruptions in breathing and swallowing coordination occurred in COPD patients outside of exacerbations during normal eating.
The researchers examined the relationship between swallowing and timing of breathing in 25 patients with moderate to severe COPD and compared them with 25 healthy subjects. Each subject was asked to consume nine wafer cookies and ten teaspoons of pudding to determine whether there were differences in the handling of solid versus semi-solid food.
The researchers found that in patients with COPD, a pattern emerged that was strikingly different from that of healthy controls.
"In healthy subjects, the usual pattern is to time swallows to occur during early to mid exhalation. Healthy individuals also nearly exclusively follow each swallow with exhalation. This pattern assures that there is sufficient air pressure below the vocal folds during a swallow and prevents inhalation of food residue after swallowing," said Dr. Gross. "In contrast, in COPD patients, we saw that several aspects of their swallowing and breathing timing were disrupted such that swallows were occurring during inhalation or where followed by inhalation. COPD patients also swallowed more often at the end of exhalation at lower lung volumes."
The complicated physiology of the upper respiratory tract may be thrown out of balance by the respiratory burden imposed by COPD, explained Dr. Gross. "Because breathing and eating share the structures of the upper airway, precise coordination is needed to prevent food material from entering the airway while eating. In patients with COPD, the competition for the upper airway may cause the respiratory drive to override swallowing function and disrupt the normal patterning. The lungs of COPD patients have less elasticity than those of healthy individuals and this may also play a role swallowing safety."
Difficulty swallowing is often related to weakness and is associated with many neurological diseases such as Parkinson's disease. The observed impaired breathing and swallowing patterns in the COPD patients suggest a possible explanation for the presence of swallowing disorders in persons that do not have neurological illness.
Dr. Gross also points out the immediate clinical implication of these findings: "Unrecognized aspiration can occur prior to or during COPD exacerbation and may contribute to the onset and severity of the exacerbations. Patients with COPD should have their swallowing function evaluated during hospitalizations and aspiration should be suspected when COPD exacerbations cannot be linked to viral infections or other factors," she said.
Further research is being conducted that examines the interactions between control of the respiratory cycle, lung elasticity and swallowing function. Currently, therapies that manipulate the respiratory system are being developed to improve swallowing function and safety.
Keely Savoie | EurekAlert!
Using fragment-based approaches to discover new antibiotics
21.06.2018 | SLAS (Society for Laboratory Automation and Screening)
Scientists learn more about how gene linked to autism affects brain
19.06.2018 | Cincinnati Children's Hospital Medical Center
In a recent publication in the renowned journal Optica, scientists of Leibniz-Institute of Photonic Technology (Leibniz IPHT) in Jena showed that they can accurately control the optical properties of liquid-core fiber lasers and therefore their spectral band width by temperature and pressure tuning.
Already last year, the researchers provided experimental proof of a new dynamic of hybrid solitons– temporally and spectrally stationary light waves resulting...
Scientists from the University of Freiburg and the University of Basel identified a master regulator for bone regeneration. Prasad Shastri, Professor of...
Moving into its fourth decade, AchemAsia is setting out for new horizons: The International Expo and Innovation Forum for Sustainable Chemical Production will take place from 21-23 May 2019 in Shanghai, China. With an updated event profile, the eleventh edition focusses on topics that are especially relevant for the Chinese process industry, putting a strong emphasis on sustainability and innovation.
Founded in 1989 as a spin-off of ACHEMA to cater to the needs of China’s then developing industry, AchemAsia has since grown into a platform where the latest...
The BMBF-funded OWICELLS project was successfully completed with a final presentation at the BMW plant in Munich. The presentation demonstrated a Li-Fi communication with a mobile robot, while the robot carried out usual production processes (welding, moving and testing parts) in a 5x5m² production cell. The robust, optical wireless transmission is based on spatial diversity; in other words, data is sent and received simultaneously by several LEDs and several photodiodes. The system can transmit data at more than 100 Mbit/s and five milliseconds latency.
Modern production technologies in the automobile industry must become more flexible in order to fulfil individual customer requirements.
An international team of scientists has discovered a new way to transfer image information through multimodal fibers with almost no distortion - even if the fiber is bent. The results of the study, to which scientist from the Leibniz-Institute of Photonic Technology Jena (Leibniz IPHT) contributed, were published on 6thJune in the highly-cited journal Physical Review Letters.
Endoscopes allow doctors to see into a patient’s body like through a keyhole. Typically, the images are transmitted via a bundle of several hundreds of optical...
13.06.2018 | Event News
08.06.2018 | Event News
05.06.2018 | Event News
22.06.2018 | Materials Sciences
22.06.2018 | Earth Sciences
22.06.2018 | Life Sciences