Upper and lower esophageal sphincter kinetics are modified during maturation: effect of pharyngeal stimulus in premature infants
We hypothesized that changes in proximal and distal esophageal sphincter kinetics evoked upon pharyngeal provocation undergo longitudinal maturation. Pharyngeal stimulation-induced reflexes were characterized using novel pharyngo-esophageal motility methods in 19 healthy premature neonates, studied at 34.7 ± 0.8 wk (time-1) and 39.3 ± 1.1 wk postmenstrual age (time-2). Graded volumes of air (290 infusions) and sterile water (172 infusions) were infused to define sensory-motor characteristics of upstream (pharyngeal reflexive swallow, PRS) and downstream (pharyngo-lower esophageal sphincter relaxation reflex, PLESRR) esophageal reflexes. Data displayed as mean ± SE. Threshold volumes were similar with air and water for PRS and PLESRR at time-1 and time-2. Multiple PRS responses were noted with water stimulus and were different between the media (time-1 vs. air, P < 0.0001; time-2 vs. air, P = 0.0003). Dose-response relationships for water were significant (P < 0.01 for PRS and PLESRR time-1 and time-2), but not with air. Significantly, the recruitment frequency of PRS and PLESRR increases with maturation, liquid is a superior medium for evoking such swallowing reflexes, and stimulus-response relationships for these reflexes are evident. These changes in aerodigestive protective reflexive activity may indicate differences in modulation of excitatory and inhibitory pathways during longitudinal postnatal maturation..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:77 |
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| Enthalten in: |
Pediatric research - 77(2015), 1-1, Seite 99-106 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jadcherla, Sudarshan R [VerfasserIn] |
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| Links: |
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| Themen: |
Esophageal Sphincter, Lower - physiology |
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| doi: |
10.1038/pr.2014.147 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC1967792291 |
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| 245 | 1 | 0 | |a Upper and lower esophageal sphincter kinetics are modified during maturation: effect of pharyngeal stimulus in premature infants |
| 264 | 1 | |c 2015 | |
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| 520 | |a We hypothesized that changes in proximal and distal esophageal sphincter kinetics evoked upon pharyngeal provocation undergo longitudinal maturation. Pharyngeal stimulation-induced reflexes were characterized using novel pharyngo-esophageal motility methods in 19 healthy premature neonates, studied at 34.7 ± 0.8 wk (time-1) and 39.3 ± 1.1 wk postmenstrual age (time-2). Graded volumes of air (290 infusions) and sterile water (172 infusions) were infused to define sensory-motor characteristics of upstream (pharyngeal reflexive swallow, PRS) and downstream (pharyngo-lower esophageal sphincter relaxation reflex, PLESRR) esophageal reflexes. Data displayed as mean ± SE. Threshold volumes were similar with air and water for PRS and PLESRR at time-1 and time-2. Multiple PRS responses were noted with water stimulus and were different between the media (time-1 vs. air, P < 0.0001; time-2 vs. air, P = 0.0003). Dose-response relationships for water were significant (P < 0.01 for PRS and PLESRR time-1 and time-2), but not with air. Significantly, the recruitment frequency of PRS and PLESRR increases with maturation, liquid is a superior medium for evoking such swallowing reflexes, and stimulus-response relationships for these reflexes are evident. These changes in aerodigestive protective reflexive activity may indicate differences in modulation of excitatory and inhibitory pathways during longitudinal postnatal maturation. | ||
| 650 | 4 | |a Esophagus - physiology | |
| 650 | 4 | |a Esophageal Sphincter, Lower - physiology | |
| 650 | 4 | |a Infant, Premature - physiology | |
| 650 | 4 | |a Pharynx - physiology | |
| 650 | 4 | |a Esophageal Sphincter, Upper - physiology | |
| 700 | 1 | |a Shubert, Theresa R |4 oth | |
| 700 | 1 | |a Gulati, Ish K |4 oth | |
| 700 | 1 | |a Jensen, Preceousa S |4 oth | |
| 700 | 1 | |a Wei, Lai |4 oth | |
| 700 | 1 | |a Shaker, Reza |4 oth | |
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| 856 | 4 | 1 | |u http://dx.doi.org/10.1038/pr.2014.147 |3 Volltext |
| 856 | 4 | 2 | |u http://www.ncbi.nlm.nih.gov/pubmed/25279989 |
| 856 | 4 | 2 | |u http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4268006&tool=pmcentrez&rendertype=abstract |
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