Journal
JOURNAL OF PEDIATRICS
Volume 151, Issue 6, Pages 597-603Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2007.04.042
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Funding
- NIDDK NIH HHS [R01 DK068158-02, R01 DK 068158, R01 DK068158, R01 DK068158-01A2] Funding Source: Medline
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Objective To test the hypothesis that the sensorimotor characteristics of the reflexes evoked on stimulation with air and water infusions differ by studying the effect of pharyngeal stimulation on pharyngeal-upper esopliageal sphincter (UES) interactions in healthy neonates. Study design Pharyngo-UES-esophageal manometry was recorded in 10 neonates at 39 +/- 4 weeks postmenstrual age. Pharyngeal infusions (n = 155) of air (0.1 to 2.0 mL) and sterile water (0.1 to 0.5 mL) were given. Two types of reflexes were recognized: pharyngeal reflexive swallowing (PRS) and pharyngo-UES-contractile reflex (PUCR). Frequency occurrence, distribution of reflexes, threshold volume, response time, and stimulus-response relationship were evaluated. Results The reflex response rates were 30% for air and 76% for water (P <.001). PRS was more frequent than PUCR with air and water (P <.05), even though the stimulation thresholds and response latencies were similar. Graded volumes of water but not air resulted in an increased frequency of PRS (P <.01). Conclusions PRS is more frequent than PUCR, and the 2 reflexes have distinctive characteristics in air and water stimuli. Both PRS and PUCR have implications for the evaluation of swallowing in infants.
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