接受肺移植评估的患者的呼吸-吞咽模式和口咽吞咽功能障碍。

IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Neurogastroenterology and Motility Pub Date : 2024-11-01 Epub Date: 2024-09-02 DOI:10.1111/nmo.14912
Kahla Graham, Erin L Reedy, Jungwha Julia Lee, Elizabeth Spencer Norton, Ambalavanan Arunachalam, Rade Tomic, Bonnie Martin-Harris
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引用次数: 0

摘要

背景:虽然肺移植后普遍存在吞咽障碍,但呼吸和吞咽的基线特征往往被忽视。呼吸系统疾病过程可能导致肺移植候选者的呼吸-吞咽模式改变和吞咽功能障碍:这项横断面研究包括在肺移植评估期间转诊进行改良吞咽钡检查的患者。采用改良钡吞咽功能障碍档案和穿透-吞咽量表测量吞咽功能障碍。分析了与视频荧光镜同步的呼吸胸透信号,以确定相位模式、停顿时间和速率。混合效应逻辑回归用于确定呼吸和吞咽测量之间的联系:共纳入了 50 名患者,他们的吞咽开始延迟(49/50)、口腔残留(37/50)、咽喉食管段开放不全(35/50)和食管滞留(43/50)。侵犯气道的情况很少发生(10/50)。非典型呼吸模式与咽吞咽启动障碍(OR [95% CI] = 1.76 [1.16, 2.68],p = 0.009)、喉头抬高(OR [95% CI] = 1.45 [1.01, 2.07],p = 0.044)和喉头前庭闭合(OR [95% CI] = 2.57 [1.48, 4.46],p 结论和推论:接受肺移植评估的患者显示出吞咽和相位模式受损。初步研究结果表明,有必要进一步评估呼吸-吞咽协调性及其在肺移植前后吞咽障碍中的潜在作用。
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Respiratory-swallow patterning and oropharyngeal swallowing impairment in patients undergoing evaluation for lung transplant.

Background: Although swallowing impairment is prevalent following lung transplantation, baseline respiratory and swallowing characteristics are often overlooked. Respiratory disease processes may predispose lung transplant candidates to altered respiratory-swallow patterning and swallowing impairment.

Methods: This cross-sectional study included patients referred for a Modified Barium Swallow Study during lung transplant evaluation. Swallowing impairment was measured using the Modified Barium Swallow Impairment Profile and Penetration-Aspiration Scale. Respiratory plethysmographic signals synchronized with videofluoroscopy were analyzed to determine phase patterning, pause duration, and rate. Mixed-effects logistic regression was used to identify linkages between respiratory and swallowing measures.

Key results: Fifty patients were included and demonstrated delayed swallow initiation (49/50), oral residue (37/50), incomplete pharyngoesophageal segment opening (35/50), and esophageal retention (43/50). Airway invasion occurred infrequently (10/50). Atypical respiratory patterning was significantly associated with impairment in pharyngeal swallow initiation (OR [95% CI] = 1.76 [1.16, 2.68], p = 0.009), laryngeal elevation (OR [95% CI] = 1.45 [1.01, 2.07], p = 0.044), and laryngeal vestibular closure (OR [95% CI] = 2.57 [1.48, 4.46], p < 0.001). Increased pause duration was associated with impaired initiation (OR [95% CI] = 2.24 [1.20, 4.16], p = 0.011), laryngeal elevation (OR [95% CI] = 1.18 [1.03, 1.36], p = 0.018), laryngeal closure (OR [95% CI] = 1.28 [1.9, 1.50], p = 0.003), and tongue base retraction (OR [95% CI] = 1.33 [1.13, 1.56], p < 0.001).

Conclusions & inferences: Patients undergoing evaluation for lung transplant demonstrated impaired swallowing and phase patterning. Preliminary findings implicate the need for further evaluation of respiratory-swallow coordination and its potential role in swallowing impairment before and after lung transplantation.

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来源期刊
Neurogastroenterology and Motility
Neurogastroenterology and Motility 医学-临床神经学
CiteScore
7.80
自引率
8.60%
发文量
178
审稿时长
3-6 weeks
期刊介绍: Neurogastroenterology & Motility (NMO) is the official Journal of the European Society of Neurogastroenterology & Motility (ESNM) and the American Neurogastroenterology and Motility Society (ANMS). It is edited by James Galligan, Albert Bredenoord, and Stephen Vanner. The editorial and peer review process is independent of the societies affiliated to the journal and publisher: Neither the ANMS, the ESNM or the Publisher have editorial decision-making power. Whenever these are relevant to the content being considered or published, the editors, journal management committee and editorial board declare their interests and affiliations.
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