COPD-related problems hard to swallow
March 26, 2009Patients with moderate to severe chronic obstructive pulmonary disease (COPD) exhibit a disordered breathing-swallowing pattern that may account for their higher risk of aspiration pneumonia, according to new research from the University of Pittsburgh.
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.
-
Depression may increase exacerbations, hospitalizations in COPD
Oct 24, 2008 |
not rated yet |
0
-
Advance toward early diagnosis of chronic obstructive pulmonary disease
Dec 08, 2008 |
not rated yet |
0
-
Common bronchodilator linked to increased deaths
Sep 15, 2008 |
not rated yet |
0
-
Long-term antibiotics reduce COPD exacerbations, raise questions
Nov 21, 2008 |
not rated yet |
0
-
FDA issues Spiriva and Foradil advisory
Mar 03, 2008 |
not rated yet |
0
-
Engineers build first sub-10-nm carbon nanotube transistor
Feb 01, 2012 |
4.9 / 5 (33) |
30
-
Something old, something new: Evolution and the structural divergence of duplicate genes
Jan 31, 2012 |
4.6 / 5 (7) |
1
-
The hidden nanoworld of ice crystals: Revealing the dynamic behavior of quasi-liquid layers
Jan 30, 2012 |
5 / 5 (4) |
1
-
Stock market network reveals investor clustering
Jan 27, 2012 |
3.9 / 5 (23) |
8
-
Of microchemistry and molecules: Electronic microfluidic device synthesizes biocompatible probes
Jan 26, 2012 |
5 / 5 (2) |
0
-
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011
- More from Physics Forums - Independent Research
More news stories
Botox developer rues missing out on billions
Botox developer Alan Scott says he rues the day he handed over rights to the best-selling wrinkle-smoothing drug to a US company for just $4.5 million, saying he might have become a billionaire.
Medicine & Health / Medications
32 minutes ago |
not rated yet |
0
Many lung cancer patients get radiation therapy that may not prolong their lives
A new study has found that many older lung cancer patients get treatments that may not help them live longer. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings suggest that p ...
27 minutes ago |
not rated yet |
0
Cancer rate 4 times higher in children with juvenile arthritis
New research reports that incident malignancy among children with juvenile idiopathic arthritis (JIA) is four times higher than in those without the disease. Findings now available in Arthritis & Rheumatism, a journal publis ...
24 minutes ago |
not rated yet |
0
Young adults allowed to stay on parents' health insurance have improved access to care
Researchers from Mount Sinai School of Medicine have found that laws permitting children to stay on their parents' health insurance through age 26 result in improved access to health care compared to states without those ...
17 minutes ago |
not rated yet |
0
Starve a virus, feed a cure? Findings show how some cells protect themselves against HIV
A protein that protects some of our immune cells from the most common and virulent form of HIV works by starving the virus of the molecular building blocks that it needs to replicate, according to research published online ...
14 hours ago |
5 / 5 (3) |
0
|
Japan's Fukushima reactor may be reheating: operator
Temperature readings at one of the crippled Fukushima nuclear reactors have risen above Japan's stringent new safety standard but there was no immediate danger, its operator said Sunday.
Integrated pest management recommendations for the southern pine beetle
The southern pine beetle, Dendroctonus frontalis Zimmermann, is a chronic insect pest within pine forests in the southeastern United States. Under favorable environmental and host conditions, it is an agg ...
AT&T customers surprised by 'unlimited data' limit
(AP) -- Mike Trang likes to use his iPhone 4 as a GPS device, helping him get around in his job. Now and then, his younger cousins get ahold of it, and play some YouTube videos and games.
Australian women reject 'I love u' texts
Australian women may have embraced the digital era, but they prefer a face-to-face declaration of affection to an "I love u" text and find men addicted to their mobile phones a major turnoff.
Scientists discover molecular secrets of 2,000-year-old Chinese herbal remedy
For roughly two thousand years, Chinese herbalists have treated Malaria using a root extract, commonly known as Chang Shan, from a type of hydrangea that grows in Tibet and Nepal. More recent studies suggest that halofuginone, ...
New method to examine batteries -- MRI from the inside
There is an ever-increasing need for advanced batteries for portable electronics, such as phones, cameras, and music players, but also to power electric vehicles and to facilitate the distribution and storage of energy derived ...