2016 Volume 20 Issue 3 Pages 114-123
Purpose: We evaluated the adjustment of breathing and deglutition in patients with chronic respiratory disease. We studied the relationship between incidence of deglutition in the inspiratory phase as a factor of aspiration and respiratory function, and weight loss as a prognostic factor of respiratory disease.
Method: We evaluated saliva (30 s), water (10 ml×5), and jelly (5 g×5) in a deglutition test in 20 patients with chronic respiratory disease including COPD, interstitial pneumonia and bronchodilatation. We used an air flow pressure sensor and a thoracic abdominal inductive sensor to detect breathing phase. We used a throat microphone for detecting the sound of deglutition, which was confirmed by the sound of deglutition occurring within the deglutition apnea period. We defined deglutition during the expiratory phase to be a normal pattern, and deglutition during the inspiratory phase as an abnormality. We analyzed the relationships of low weight and number of times of deglutition in the inspiratory phase, and investigated the correlation between deglutition in the inspiratory phase and respiratory function.
Result: In the saliva and water deglutition test, deglutition in the inspiratory phase was associated with low weight (saliva: p＜0.05, water: p＜0.01). In the water deglutition test, TV was significantly associated with deglutition in the inspiratory phase (p＜0.05). Quantity of muscle mass (AMC: p＜0.01) and respiratory function (IC: p＜0.01) were significantly lower in the group with lower body weight, and muscular strength (grip) and exercise tolerance (6MWD) showed lower levels in the group with lower body weight similarly.
Discussion: Deglutition which occurred prior to inspiration or occurred subsequently was found at high frequency in the patients with chronic respiratory disease. Deglutition in the inspiratory phase was found at a significantly high frequency in the group with low weight. It is suggested that weight loss suggesting sarcopenia may be a factor of abnormal adjustment of respiration and deglutition.
