Document Detail

Co-ordination of spontaneous swallowing with respiratory airflow and diaphragmatic and abdominal muscle activity in healthy adult humans.
MedLine Citation:
PMID:  19139059     Owner:  NLM     Status:  MEDLINE    
Co-ordination of breathing and swallowing is essential for normal pharyngeal function and to protect the airway. To allow for safe passage of a bolus through the pharynx, respiration is interrupted (swallowing apnoea); however, the control of airflow and diaphragmatic activity during swallowing and swallowing apnoea are not fully understood. Here, we validated a new airflow discriminator for detection of respiratory airflow and used it together with diaphragmatic and abdominal electromyography (EMG), spirometry and pharyngeal and oesophageal manometry. Co-ordination of breathing and spontaneous swallowing was examined in six healthy volunteers at rest, during hypercapnia and when breathing at 30 breaths min(-1). The airflow discriminator proved highly reliable and enabled us to determine timing of respiratory airflow unambiguously in relation to pharyngeal and diaphragmatic activity. During swallowing apnoea, the passive expiration of the diaphragm was interrupted by static activity, i.e. an 'active breath holding', which preserved respiratory volume for expiration after swallowing. Abdominal EMG increased throughout pre- and post-swallowing expiration, more so during hyper- than normocapnia, possibly to assist expiratory airflow. In these six volunteers, swallowing was always preceded by expiration, and 93 and 85% of swallows were also followed by expiration in normo- and hypercapnia, respectively, indicating that, in man, swallowing during the expiratory phase of breathing may be even more predominant than previously believed. This co-ordinated pattern of breathing and swallowing potentially reduces the risk for aspiration. Insights from these measurements in healthy volunteers and the airflow discriminator will be used for future studies on airway protection and effects of disease, drugs and ageing.
Anna I Hårdemark Cedborg; Eva Sundman; Katarina Bodén; Hanne Witt Hedström; Richard Kuylenstierna; Olle Ekberg; Lars I Eriksson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2009-01-12
Journal Detail:
Title:  Experimental physiology     Volume:  94     ISSN:  1469-445X     ISO Abbreviation:  Exp. Physiol.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-16     Completed Date:  2009-05-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9002940     Medline TA:  Exp Physiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  459-68     Citation Subset:  IM    
Department of Anaesthesiology and Intensive Care Medicine, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
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MeSH Terms
Abdominal Muscles / physiopathology*
Diagnostic Techniques, Respiratory System* / instrumentation
Diaphragm / physiopathology*
Equipment Design
Hypercapnia / physiopathology*
Pharynx / physiopathology*
Reproducibility of Results
Time Factors
Young Adult
Comment In:
Exp Physiol. 2009 Apr;94(4):398-9   [PMID:  19286642 ]

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