Strategies for the Integration of Cough and Swallow to Maintain Airway Protection in Humans

Lung. 2018 Oct;196(5):601-608. doi: 10.1007/s00408-018-0133-7. Epub 2018 Jun 20.

Abstract

Purpose: Airway protective behaviors, like cough and swallow, deteriorate in many populations suffering from neurologic disorders. While coordination of these behaviors has been investigated in an animal model, it has not been tested in humans.

Methods: We used a novel protocol, adapted from previous work in the cat, to assess cough and swallow independently and their coordination strategies in seven healthy males (26 ± 6 years). Surface electromyograms of the submental complex and external oblique complex, spirometry, and thoracic and abdominal wall kinematics, were used to evaluate the timing of swallow, cough, and breathing as well as lung volume (LV) during these behaviors.

Results: Unlike the cat, there was significant variability in the cough-swallow phase preference; however, there was a targeted LV range in which swallow occurred.

Conclusion: These results give insight into the differences between the cat and human models in airway protective strategies related to the coordination of cough and swallow behaviors, allowing for better understanding of dystussia and dysphagia.

Keywords: Airflow; Apnea duration; Lung volume; Surface electromyography; Volume related feedback.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Wall / physiology*
  • Adult
  • Animals
  • Biomechanical Phenomena
  • Cats
  • Cough*
  • Deglutition*
  • Electromyography
  • Healthy Volunteers
  • Humans
  • Lung / physiology*
  • Male
  • Respiratory Aspiration / etiology
  • Respiratory Aspiration / physiopathology
  • Respiratory Aspiration / prevention & control*
  • Respiratory Mechanics*
  • Species Specificity
  • Spirometry
  • Thoracic Wall / physiology*
  • Time Factors
  • Young Adult