Piecemeal Deglutition and the Implications for Pressure Impedance Dysphagia Assessment in Pediatrics
| Autor: | Nathalie Rommel, Warwick J. Teague, Sebastian K. King, Lara Ferris, Taher Omari, Sebastian Doeltgen, Lisa McCall, Ingrid Scholten |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Manometry medicine.medical_treatment Distension Asymptomatic Pediatrics 03 medical and health sciences 0302 clinical medicine Bolus (medicine) stomatognathic system Swallowing Internal medicine otorhinolaryngologic diseases medicine Electric Impedance Pressure Humans Saline Retrospective Studies business.industry digestive oral and skin physiology Pharynx Gastroenterology Infant Esophageal Sphincter Upper Dysphagia Biomechanical Phenomena Deglutition medicine.anatomical_structure Child Preschool Pediatrics Perinatology and Child Health Cardiology 030211 gastroenterology & hepatology Female medicine.symptom business Deglutition Disorders 030217 neurology & neurosurgery Oropharyngeal dysphagia Muscle Contraction |
| Zdroj: | Journal of pediatric gastroenterology and nutrition. 67(6) |
| ISSN: | 1536-4801 |
| Popis: | OBJECTIVES High-resolution impedance manometry (HRIM) enables biomechanical swallow assessment. Piecemeal deglutition (PD) defines swallowing of a single bolus in 2 or more portions. We investigated PD sequences on HRIM recordings to ascertain appropriate swallow selection for analysis and to determine the impact of PD on swallow function measures. METHODS Pharyngo-esophageal motility and bolus flow were assessed in 27 children (19 M, mean age 15 months) with repaired esophageal atresia and trachea-esophageal fistula, but who were asymptomatic of oropharyngeal dysphagia. A consistent volume of between 2 and 5 mL saline boluses was given to each patient. Retrospectively, PD sequences were defined based on the number of swallows required to clear the bolus from the oral cavity: pattern A = 1-2 swallows; pattern B = 3 swallows; and pattern C = 4+ swallows. The largest bolus volume swallowed was noted as the dominant swallow in each pattern. Pressure Flow Analysis defined contractility, distension and flow timing metrics. Data were averaged for each PD pattern, and compared with dominant swallows from each pattern. RESULTS PD pattern B (43.7%) was the most prevalent across the cohort. PD patterns were similarly distributed across age groups (G1 |
| Databáze: | OpenAIRE |
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