Efficacy and Safety of "Vacuum Swallowing" Based on a Strong Negative Esophageal Pressure in Healthy Individuals.

Deglutition disorders Esophagus Inspiratory muscles Lateral medullary syndrome Lower esophageal sphincter Manometry

Journal

Dysphagia
ISSN: 1432-0460
Titre abrégé: Dysphagia
Pays: United States
ID NLM: 8610856

Informations de publication

Date de publication:
17 Aug 2024
Historique:
received: 06 04 2023
accepted: 27 07 2024
medline: 17 8 2024
pubmed: 17 8 2024
entrez: 17 8 2024
Statut: aheadofprint

Résumé

Vacuum swallowing is a unique method for improving the pharyngeal passage of a bolus by creating subatmospheric negative pressure in the esophagus. However, whether healthy individuals and other patients with dysphagia can reproduce vacuum swallowing remains unclear. Therefore, this study aimed to assess whether healthy individuals verified using high-resolution manometry (HRM) could reproduce vacuum swallowing and evaluate its safety using a swallowing and breathing monitoring system (SBMS). Two healthy individuals who mastered vacuum swallowing taught this method to 12 healthy individuals, who performed normal and vacuum swallowing with 5 mL of water five times each. The minimum esophageal pressure and the maximum pressure of the lower esophageal sphincter (LES) were evaluated during each swallow using the HRM. Additionally, respiratory-swallowing coordination was evaluated using the SBMS. Ten individuals reproduced vacuum swallowing, and a total of 50 vacuum swallows were analyzed. The minimum esophageal pressure (-15.0 ± 4.9 vs. -46.6 ± 16.7 mmHg; P < 0.001) was significantly lower, and the maximum pressure of the LES (25.4 ± 37.7 vs. 159.5 ± 83.6 mmHg; P < 0.001) was significantly higher during vacuum swallowing. The frequencies of the I-SW and SW-I patterns in vacuum swallowing were 38.9% and 0%, respectively, using the SBMS. Vacuum swallowing could be reproduced safely in healthy participants with instruction. Therefore, instructing exhalation before and after vacuum swallowing is recommended to prevent aspiration.

Identifiants

pubmed: 39153047
doi: 10.1007/s00455-024-10741-y
pii: 10.1007/s00455-024-10741-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

Marik P. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med. 2001;344:665–71. https://doi.org/10.1056/NEJM200103013440908 .
doi: 10.1056/NEJM200103013440908 pubmed: 11228282
Doggett DL, Tappe KA, Mitchell MD, Chapell R, Coates V, Turkelson CM. Prevention of pneumonia in elderly stroke patients by systematic diagnosis and treatment of dysphagia: an evidence-based comprehensive analysis of the literature. Dysphagia. 2001;16:279–95. https://doi.org/10.1007/s00455-001-0087-3 .
doi: 10.1007/s00455-001-0087-3 pubmed: 11720404
Rees CJ, Fordham T, Belafsky PC. Transnasal balloon dilation of the esophagus. Arch Otolaryngol Head Neck Surg. 2009;135:781–3. https://doi.org/10.1001/archoto.2009.115 .
doi: 10.1001/archoto.2009.115 pubmed: 19687398
Shaker R, Easterling C, Kern M, Nitschke T, Massey B, Daniels S, Grande B, Kazandjian M, Dikeman K. Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening. Gastroenterology. 2002;122:1314–21. https://doi.org/10.1053/gast.2002.32999 .
doi: 10.1053/gast.2002.32999 pubmed: 11984518
Lee SY, Seo HG, Paik NJ. Botulinum toxin injection for dysphagia: a blinded retrospective videofluoroscopic swallowing study analysis. Am J Phys Med Rehabil. 2009;88:491–4. https://doi.org/10.1097/PHM.0b013e3181a0dc47 .
doi: 10.1097/PHM.0b013e3181a0dc47 pubmed: 19325455
Buchholz DW. Cricopharyngeal myotomy may be effective treatment for selected patients with neurogenic oropharyngeal dysphagia. Dysphagia. 1995;10:255–8. https://doi.org/10.1007/BF00431418 .
doi: 10.1007/BF00431418 pubmed: 7493506
Muñoz AA, Shapiro J, Cuddy LD, Bhattacharyya N. Videofluoroscopic findings in dysphagic patients with cricopharyngeal dysfunction: before and after open cricopharyngeal myotomy. Ann Otol Rhinol Laryngol. 2007;116:49–56. https://doi.org/10.1177/000348940711600109 .
doi: 10.1177/000348940711600109 pubmed: 17305278
Hojo K, Fujishima I, Ohkuma R, Kojima C, Takehara I, Shibamoto I, Tanaka S. Balloon catheter treatment methods for cricopharyngeal dysphagia. Jpn J Dysphagia Rehabil. 1997;1:45–56. [in Japanese].
Logemann JA, Kahrilas PJ, Kobara M, Vakil NB. The benefit of head rotation on pharyngoesophageal dysphagia. Arch Phys Med Rehabil. 1989;70:767–71.
pubmed: 2802957
McCulloch TM, Hoffman MR, Ciucci MR. High resolution manometry of pharyngeal swallow pressure events associated with head turn and chin tuck. Ann Otol Rhinol Laryngol. 2010;119:369–76. https://doi.org/10.1177/000348941011900602 .
doi: 10.1177/000348941011900602 pubmed: 20583734 pmcid: 3045033
Lewin JS, Herbert TM, Putnam JB, DuBrow RA. Experience with the chin tuck maneuver in postesophagectomy aspirators. Dysphagia. 2001;16:216–9. https://doi.org/10.1007/s00455-001-0068-6 .
doi: 10.1007/s00455-001-0068-6 pubmed: 11453570
Rasley A, Logemann JA, Kahrilas PJ, Rademaker AW, Pauloski BR, Dodds WJ. Prevention of barium aspiration during videofluoroscopic swallowing studies: value of change in posture. AJR Am J Roentgenol. 1993;160:1005–9. https://doi.org/10.2214/ajr.160.5.8470567 .
doi: 10.2214/ajr.160.5.8470567 pubmed: 8470567
Bülow M, Olsson R, Ekberg O. Videomanometric analysis of supraglottic swallow, effortful swallow, and Chin tuck in patients with pharyngeal dysfunction. Dysphagia. 2001;16:190–5. https://doi.org/10.1007/s00455-001-0065-9 .
doi: 10.1007/s00455-001-0065-9 pubmed: 11453566
Terré R, Mearin F. Effectiveness of chin-down posture to prevent tracheal aspiration in dysphagia secondary to acquired brain injury. A videofluoroscopy study. Neurogastroenterol Motil. 2012;24:414–9. https://doi.org/10.1111/j.1365-2982.2011.01869.x .
doi: 10.1111/j.1365-2982.2011.01869.x pubmed: 22309385
Kunieda K, Kubo S, Fujishima I. A new swallowing method to improve pharyngeal passage of a bolus by creating negative pressure in the esophagus-vacuum swallowing. Am J Phys Med Rehabil. 2018;97:e81–4. https://doi.org/10.1097/PHM.0000000000000872 .
doi: 10.1097/PHM.0000000000000872 pubmed: 29194048 pmcid: 6092101
Kunieda K, Sugiyama J, Nomoto A, Ohno T, Shigematsu T, Fujishima I. Compensatory swallowing methods in a patient with dysphagia due to lateral medullary syndrome—vacuum and prolonged swallowing: a case report. Medicine. 2022;101:e28524. https://doi.org/10.1097/md.0000000000028524 .
doi: 10.1097/md.0000000000028524 pubmed: 35029918 pmcid: 8735762
Jang SH, Kim MS. Dysphagia in lateral medullary syndrome: a narrative review. Dysphagia. 2021;36:329–38. https://doi.org/10.1007/s00455-020-10158-3 .
doi: 10.1007/s00455-020-10158-3 pubmed: 32654058
Jones CA, Colletti CM, Ding MC. Post-stroke dysphagia: recent insights and unanswered questions neurorehabilitation and recovery. Curr Neurol Neurosci Rep. 2020;20:61. https://doi.org/10.1007/s11910-020-01081-z .
doi: 10.1007/s11910-020-01081-z pubmed: 33136216 pmcid: 7604228
Kunieda K, Kubo S, Fujishima I. A new swallowing method to improve pharyngeal passage by creating negative pressure in the esophagus—vacuum swallowing: reproduction in normal subjects. Deglutition. 2018;7:224–30.
Fox MR, Bredenoord AJ. Oesophageal high-resolution manometry: moving from research into clinical practice. Gut. 2008;57:405–23. https://doi.org/10.1136/gut.2007.127993 .
doi: 10.1136/gut.2007.127993 pubmed: 17895358
Juan J, Hind J, Jones C, McCulloch T, Gangnon R, Robbins J. Case study: application of isometric progressive resistance oropharyngeal therapy using the Madison oral strengthening therapeutic device. Top Stroke Rehabil. 2013;20:450–70. https://doi.org/10.1310/tsr2005-450 .
doi: 10.1310/tsr2005-450 pubmed: 24091287
Yagi N, Nagami S, Lin MK, Yabe T, Itoda M, Imai T, Oku Y. A noninvasive swallowing measurement system using a combination of respiratory flow, swallowing sound, and laryngeal motion. Med Biol Eng Comput. 2017;55:1001–17. https://doi.org/10.1007/s11517-016-1561-2 .
doi: 10.1007/s11517-016-1561-2 pubmed: 27665103
Gross RD, Atwood CW Jr, Ross SB, Olszewski JW, Eichhorn KA. The coordination of breathing and swallowing in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2009;179:559–65. https://doi.org/10.1164/rccm.200807-1139oc .
doi: 10.1164/rccm.200807-1139oc pubmed: 19151193
Nagami S, Oku Y, Yagi N, Sato S, Uozumi R, Morita S, Yamagata Y, Kayashita J, Tanimura K, Sato A, Takahashi R, Muro S. Breathing-swallowing discoordination is associated with frequent exacerbations of COPD. BMJ Open Respir Res. 2017;4:e000202. https://doi.org/10.1136/bmjresp-2017-000202 .
doi: 10.1136/bmjresp-2017-000202 pubmed: 28883930 pmcid: 5531308
Yagi N, Oku Y, Nagami S, Yamagata Y, Kayashita J, Ishikawa A, Domen K, Takahashi R. Inappropriate timing of swallow in the respiratory cycle causes breathing-swallowing discoordination. Front Physiol. 2016;8:676. https://doi.org/10.3389/fphys.2017.00676 .
doi: 10.3389/fphys.2017.00676
Rosen RD, Winters R. Physiology, lower esophageal sphincter. StatPearls [Internet]. Treasure Island (FL); 2023.
Oku Y. Coordination of swallowing and breathing: how is the respiratory control system connected to the swallowing system? In: Yamaguchi K, editor. Structure-function relationships in various respiratory systems. Berlin: Springer; 2020. pp. 37–52.
doi: 10.1007/978-981-15-5596-1_3
Hopkins-Rossabi T, Curtis P, Temenak M, Miller C, Martin-Harris B. Respiratory phase and lung volume patterns during swallowing in healthy adults: a systematic review and meta-analysis. J Speech Lang Hear Res. 2019;62:868–82. https://doi.org/10.1044/2018_jslhr-s-18-0323 .
doi: 10.1044/2018_jslhr-s-18-0323 pubmed: 30964715 pmcid: 6802879
Logemann JA. Manual for the videofluoroscopic study of swallowing. New York, NY: Springer; 1993.
Udeshi A, Cantie SM, Pierre E. Postobstructive pulmonary edema. J Crit Care. 2010;25:e5081–5. https://doi.org/10.1016/j.jcrc.2009.12.014 .
doi: 10.1016/j.jcrc.2009.12.014

Auteurs

Kenjiro Kunieda (K)

Department of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Gifu, 501-1194, Japan. ken2rou.k@gmail.com.
Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, Japan. ken2rou.k@gmail.com.

Saori Suzuki (S)

Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, Japan.

Satoe Naganuma (S)

Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, Japan.

Keishi Okamoto (K)

Department of Rehabilitation, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, Japan.

Tomohisa Ohno (T)

Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, Japan.

Takashi Shigematsu (T)

Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, Japan.

Naomi Yagi (N)

Advanced Medical Engineering Research Institute, University of Hyogo, Himeji, Hyogo, Japan.

Yoshitaka Oku (Y)

Department of Physiology, Hyogo Medical University, Nishinomiya, Hyogo, Japan.

Ichiro Fujishima (I)

Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, Japan.

Classifications MeSH