Effect of nasal continuous or intermittent positive airway pressure on nonnutritive swallowing in the newborn lamb.
The present study was aimed at investigating the effects of nasal continuous positive airway pressure (nCPAP; 6 cmH2O) or intermittent positive pressure ventilation (nIPPV; 10/4 cmH2O) on nonnutritive swallowing (NNS) and on the coordination between NNS and phases of the respiratory cycle, while taking into account the potential effects of states of alertness. Twelve full-term lambs were chronically instrumented at 48 h after birth for polysomnographic recordings, including NNS, diaphragm electromyographic activity, respiratory movements, pulse oximetry, and states of alertness. Studies in control conditions, with nCPAP and nIPPV, were performed in random order in nonsedated lambs at 4, 5, and 6 days of life. Results demonstrate that nCPAP significantly decreased overall NNS frequency, more specifically isolated NNS during quiet sleep and bursts of NNS in active sleep. In comparison, the effects of nIPPV on NNS frequency were more variable, with an inhibition of NNS only in wakefulness and an increase in isolated NNS frequency in active sleep. In addition, neither nCPAP nor nIPPV disrupted the coordination between NNS and phases of the respiratory cycle. In conclusion, nCPAP inhibits NNS occurrence in newborn lambs. Clinical relevance of this novel finding is related to the importance of NNS for clearing the upper airways from secretions and gastric content frequently regurgitated in the neonatal period.
Neonatal Respiratory Research Unit, Department of Pediatrics, University of Sherbrooke, Sherbrooke, Quebec, Canada.
Nathalie
N
Samson
Marie
M
St-Hilaire
Elise
E
Nsegbe
Philippe
P
Reix
François
F
Moreau-Bussière
Jean-Paul
JP
Praud
D000818:Animals; D000831:Animals, Newborn; D002245:Carbon Dioxide / Q000097:blood; D045422:Continuous Positive Airway Pressure; D003679:Deglutition / Q000502:physiology*; D005260:Female; D007385:Intermittent Positive-Pressure Ventilation; D007830:Larynx / Q000502:physiology; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D015656:Respiratory Mechanics / Q000502:physiology*; D012756:Sheep; D013686:Telemetry; D014851:Wakefulness / Q000502:physiology
D002245:Carbon Dioxide; D010100:Oxygen