title: Pulmonary function in infants with swallowing dysfunction.
abstract: BACKGROUND
  Swallowing dysfunction can lead to recurring aspiration and is frequently associated with chronic symptoms such as cough and wheezing in infants. Our objective was to describe the characteristics of infants with swallowing dysfunction, determine if pulmonary function abnormalities are detectable, and if they improve after therapy.
  
  
  METHODS
  We studied 38 infants with a history of coughing and wheezing who had pulmonary function tests performed within two weeks of their diagnosis of swallowing dysfunction. The raised lung volume rapid thoracoabdominal compression technique was used. After 6 months of therapy, 17 of the infants repeated the tests.
  
  
  RESULTS
  Initially, 25 had abnormal spirometry, 18 had abnormal plethysmography, and 15 demonstrated bronchodilator responsiveness. Six months later test were repeated for seventeen patients. Ten patients had continued abnormal spirometry, two patients remained normal, three patients' abnormal spirometry had normalized, and two patients' previously normal studies became abnormal. Eight of the 17 patients had continued abnormal plethysmography, six had continued normal plethysmography, and three patients' normal plethysmography became abnormal. After 6 months of treatment, eight patients demonstrated bronchodilator responsiveness, of which five continued to demonstrate bronchodilator responsiveness and three developed responsiveness. The remainder either continued to be non- bronchodilator responsive (two) or lost responsiveness (three.) The findings of the abnormal tests in most infants tested is complicated by frequent occurrence of other co-morbidities in this population, including gastroesophageal reflux in 23 and passive smoke exposure in 13 of the infants.
  
  
  CONCLUSIONS
  The interpretation of lung function changes is complicated by the frequent association of swallowing dysfunction with gastroesophageal reflux and passive smoke exposure in this population. Six months of medical therapy for swallowing dysfunction/gastroesophageal reflux did not significantly improve pulmonary function in these infants. Long-term studies will be necessary to determine which of these changes persists into adulthood.
authors.affiliation: Program in Pediatric Pulmonary Medicine, University of Tennessee Health Science Center, Le Bonheur Children's Hospital and St. Jude Children's Research Hospital, Memphis, TN, United States of America.
authors.forename: James D
authors.initials: JD
authors.lastname: Tutor
authors.affiliation: Program in Pediatric Pulmonary Medicine, University of Tennessee Health Science Center, Le Bonheur Children's Hospital and St. Jude Children's Research Hospital, Memphis, TN, United States of America.
authors.forename: Saumini
authors.initials: S
authors.lastname: Srinivasan
authors.affiliation: Rehabilitation Services-Department of Speech-Language Pathology, Le Bonheur Children's Hospital, Memphis, TN, United States of America; Department of Communicative Disorders, The University of Alabama, Tuscaloosa, AL, United States of America.
authors.forename: Memorie M
authors.initials: MM
authors.lastname: Gosa
authors.affiliation: Departments of Pediatrics and Preventive Medicine, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, TN, United States of America.
authors.forename: Thomas
authors.initials: T
authors.lastname: Spentzas
authors.affiliation: Program in Pediatric Pulmonary Medicine, University of Tennessee Health Science Center, Le Bonheur Children's Hospital and St. Jude Children's Research Hospital, Memphis, TN, United States of America.
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Stokes
mesh_terms: D000293:Adolescent; D002648:Child; D003371:Cough / Q000503:physiopathology; D003679:Deglutition / Q000502:physiology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology; D006801:Humans; D008297:Male; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000503:physiopathology