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Hypercapnia enhances the development of coughing during continuous infusion of water into the pharynx
We investigated the effects of increasing CO2 ventilatory drive on the coordination of respiration and reflex swallowing elicited by continuous infusion of distilled water into the pharynx (2.5 ml/min) in 11 normal subjects. Ventilation was monitored using a pneumotachograph and swallowing was recor...
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| Published in: | American journal of respiratory and critical care medicine 1998-03, Vol.157 (3), p.815-821 |
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| cites | cdi_FETCH-LOGICAL-c331t-29481684a5530488dd64229612f17e0f2b92f0d4fc5ecccdcd5f6355f35ad20f3 |
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| container_issue | 3 |
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| container_title | American journal of respiratory and critical care medicine |
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| creator | NISHINO, T HASEGAWA, R IDE, T ISONO, S |
| description | We investigated the effects of increasing CO2 ventilatory drive on the coordination of respiration and reflex swallowing elicited by continuous infusion of distilled water into the pharynx (2.5 ml/min) in 11 normal subjects. Ventilation was monitored using a pneumotachograph and swallowing was recorded by submental electromyogram. The CO2 ventilatory drive was increased by addition of external dead space, while ventilation, the frequency of swallows, and the timing of swallows in relation to the phases of the respiratory cycle were measured at steady-state conditions. We found that the CO2 ventilatory response is not influenced by continuous reflex swallowing but that hypercapnia influences the timing and frequency of these swallows. Signs of aspiration were never observed during continuous infusion of water at eucapnia, but seven of 11 subjects showed laryngeal irritation and/or pending aspiration during hypercapnia, and the incidence of laryngeal irritation was higher the greater the PCO2. Detailed analysis of laryngeal irritations consisting of single coughs in seven subjects revealed that the majority of laryngeal irritations occurred when swallows coincided with expiratory-inspiratory transition or when swallows coincided with inspiration, whereas laryngeal irritation after an expiratory swallow was never observed. These results suggest that the automatic respiratory control system is not influenced by continuous swallowing but that the coordination of swallowing and respiration may be compromised during hypercapnia. |
| doi_str_mv | 10.1164/ajrccm.157.3.9707158 |
| format | article |
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Ventilation was monitored using a pneumotachograph and swallowing was recorded by submental electromyogram. The CO2 ventilatory drive was increased by addition of external dead space, while ventilation, the frequency of swallows, and the timing of swallows in relation to the phases of the respiratory cycle were measured at steady-state conditions. We found that the CO2 ventilatory response is not influenced by continuous reflex swallowing but that hypercapnia influences the timing and frequency of these swallows. Signs of aspiration were never observed during continuous infusion of water at eucapnia, but seven of 11 subjects showed laryngeal irritation and/or pending aspiration during hypercapnia, and the incidence of laryngeal irritation was higher the greater the PCO2. Detailed analysis of laryngeal irritations consisting of single coughs in seven subjects revealed that the majority of laryngeal irritations occurred when swallows coincided with expiratory-inspiratory transition or when swallows coincided with inspiration, whereas laryngeal irritation after an expiratory swallow was never observed. These results suggest that the automatic respiratory control system is not influenced by continuous swallowing but that the coordination of swallowing and respiration may be compromised during hypercapnia.</description><identifier>ISSN: 1073-449X</identifier><identifier>EISSN: 1535-4970</identifier><identifier>DOI: 10.1164/ajrccm.157.3.9707158</identifier><identifier>PMID: 9517596</identifier><language>eng</language><publisher>New York, NY: American Lung Association</publisher><subject>Adult ; Biological and medical sciences ; Carbon Dioxide - administration & dosage ; Carbon Dioxide - blood ; Cough - etiology ; Cough - physiopathology ; Deglutition - physiology ; Electromyography ; Female ; Foreign Bodies - etiology ; Gagging - physiology ; Humans ; Hypercapnia - physiopathology ; Inhalation - physiology ; Investigative techniques, diagnostic techniques (general aspects) ; Larynx ; Male ; Medical sciences ; Middle Aged ; Pathology. Cytology. Biochemistry. Spectrometry. 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Ventilation was monitored using a pneumotachograph and swallowing was recorded by submental electromyogram. The CO2 ventilatory drive was increased by addition of external dead space, while ventilation, the frequency of swallows, and the timing of swallows in relation to the phases of the respiratory cycle were measured at steady-state conditions. We found that the CO2 ventilatory response is not influenced by continuous reflex swallowing but that hypercapnia influences the timing and frequency of these swallows. Signs of aspiration were never observed during continuous infusion of water at eucapnia, but seven of 11 subjects showed laryngeal irritation and/or pending aspiration during hypercapnia, and the incidence of laryngeal irritation was higher the greater the PCO2. Detailed analysis of laryngeal irritations consisting of single coughs in seven subjects revealed that the majority of laryngeal irritations occurred when swallows coincided with expiratory-inspiratory transition or when swallows coincided with inspiration, whereas laryngeal irritation after an expiratory swallow was never observed. These results suggest that the automatic respiratory control system is not influenced by continuous swallowing but that the coordination of swallowing and respiration may be compromised during hypercapnia.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Carbon Dioxide - administration & dosage</subject><subject>Carbon Dioxide - blood</subject><subject>Cough - etiology</subject><subject>Cough - physiopathology</subject><subject>Deglutition - physiology</subject><subject>Electromyography</subject><subject>Female</subject><subject>Foreign Bodies - etiology</subject><subject>Gagging - physiology</subject><subject>Humans</subject><subject>Hypercapnia - physiopathology</subject><subject>Inhalation - physiology</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Larynx</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Pharynx - physiology</subject><subject>Respiration - physiology</subject><subject>Respiratory Center - physiology</subject><subject>Respiratory Dead Space - physiology</subject><subject>Respiratory system</subject><subject>Space life sciences</subject><subject>Tidal Volume</subject><subject>Time Factors</subject><subject>Water - administration & dosage</subject><issn>1073-449X</issn><issn>1535-4970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><recordid>eNo9kE1r3DAQhkVoSPP1DxLwofTmjT4t61iWNBsI9NJAbkKRRlkvtuRKdtv8-2izZk8jzTzzMjwI3RC8IqThd2aXrB1WRMgVWymJJRHtCTongomal_-X8saS1Zyrl6_oIucdxoS2BJ-hMyWIFKo5R7B5HyFZM4bOVBC2JljI1bSFysFf6OM4QJiq6Csb57dtF94qN6d9sTFMXZjjnKsu-Dl3Meyxf2aCVDpT_AwZtya9h_9X6NSbPsP1Ui_R88_73-tN_fTr4XH946m2jJGppoq3pGm5EYJh3rbONZxS1RDqiQTs6auiHjvurQBrrbNO-IYJ4ZkwjmLPLtH3Q-6Y4p8Z8qSHLlvoexOgXKqlkpy2kheQH0CbYs4JvB5TN5RbNcF6b1cf7OpiVzO92C1rt0v-_DqAOy4tOsv82zI32Zrep6Kzy0eMFqpRkn0AVPOGJA</recordid><startdate>19980301</startdate><enddate>19980301</enddate><creator>NISHINO, T</creator><creator>HASEGAWA, R</creator><creator>IDE, T</creator><creator>ISONO, S</creator><general>American Lung Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19980301</creationdate><title>Hypercapnia enhances the development of coughing during continuous infusion of water into the pharynx</title><author>NISHINO, T ; HASEGAWA, R ; IDE, T ; ISONO, S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c331t-29481684a5530488dd64229612f17e0f2b92f0d4fc5ecccdcd5f6355f35ad20f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Carbon Dioxide - administration & dosage</topic><topic>Carbon Dioxide - blood</topic><topic>Cough - etiology</topic><topic>Cough - physiopathology</topic><topic>Deglutition - physiology</topic><topic>Electromyography</topic><topic>Female</topic><topic>Foreign Bodies - etiology</topic><topic>Gagging - physiology</topic><topic>Humans</topic><topic>Hypercapnia - physiopathology</topic><topic>Inhalation - physiology</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Larynx</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Pharynx - physiology</topic><topic>Respiration - physiology</topic><topic>Respiratory Center - physiology</topic><topic>Respiratory Dead Space - physiology</topic><topic>Respiratory system</topic><topic>Space life sciences</topic><topic>Tidal Volume</topic><topic>Time Factors</topic><topic>Water - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>NISHINO, T</creatorcontrib><creatorcontrib>HASEGAWA, R</creatorcontrib><creatorcontrib>IDE, T</creatorcontrib><creatorcontrib>ISONO, S</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of respiratory and critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>NISHINO, T</au><au>HASEGAWA, R</au><au>IDE, T</au><au>ISONO, S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypercapnia enhances the development of coughing during continuous infusion of water into the pharynx</atitle><jtitle>American journal of respiratory and critical care medicine</jtitle><addtitle>Am J Respir Crit Care Med</addtitle><date>1998-03-01</date><risdate>1998</risdate><volume>157</volume><issue>3</issue><spage>815</spage><epage>821</epage><pages>815-821</pages><issn>1073-449X</issn><eissn>1535-4970</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>We investigated the effects of increasing CO2 ventilatory drive on the coordination of respiration and reflex swallowing elicited by continuous infusion of distilled water into the pharynx (2.5 ml/min) in 11 normal subjects. Ventilation was monitored using a pneumotachograph and swallowing was recorded by submental electromyogram. The CO2 ventilatory drive was increased by addition of external dead space, while ventilation, the frequency of swallows, and the timing of swallows in relation to the phases of the respiratory cycle were measured at steady-state conditions. We found that the CO2 ventilatory response is not influenced by continuous reflex swallowing but that hypercapnia influences the timing and frequency of these swallows. Signs of aspiration were never observed during continuous infusion of water at eucapnia, but seven of 11 subjects showed laryngeal irritation and/or pending aspiration during hypercapnia, and the incidence of laryngeal irritation was higher the greater the PCO2. Detailed analysis of laryngeal irritations consisting of single coughs in seven subjects revealed that the majority of laryngeal irritations occurred when swallows coincided with expiratory-inspiratory transition or when swallows coincided with inspiration, whereas laryngeal irritation after an expiratory swallow was never observed. These results suggest that the automatic respiratory control system is not influenced by continuous swallowing but that the coordination of swallowing and respiration may be compromised during hypercapnia.</abstract><cop>New York, NY</cop><pub>American Lung Association</pub><pmid>9517596</pmid><doi>10.1164/ajrccm.157.3.9707158</doi><tpages>7</tpages></addata></record> |
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| ispartof | American journal of respiratory and critical care medicine, 1998-03, Vol.157 (3), p.815-821 |
| issn | 1073-449X 1535-4970 |
| language | eng |
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| source | Freely Accessible Science Journals - check A-Z of ejournals; EZB Electronic Journals Library |
| subjects | Adult Biological and medical sciences Carbon Dioxide - administration & dosage Carbon Dioxide - blood Cough - etiology Cough - physiopathology Deglutition - physiology Electromyography Female Foreign Bodies - etiology Gagging - physiology Humans Hypercapnia - physiopathology Inhalation - physiology Investigative techniques, diagnostic techniques (general aspects) Larynx Male Medical sciences Middle Aged Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Pharynx - physiology Respiration - physiology Respiratory Center - physiology Respiratory Dead Space - physiology Respiratory system Space life sciences Tidal Volume Time Factors Water - administration & dosage |
| title | Hypercapnia enhances the development of coughing during continuous infusion of water into the pharynx |
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