title: Coordination between respiration and swallowing during non-invasive positive pressure ventilation.
abstract: The purpose of this study was to test the hypothesis that the risk of silent aspiration is increased in non-invasive positive pressure ventilation.
  
  
  
  We analysed the coordination between respiration and swallowing, in 12 young volunteers and 10 elder volunteers, by simultaneously monitoring respiratory flow, laryngeal movement and swallowing sound in three different conditions: control, continuous positive airway pressure (CPAP), and bi-level positive airway pressure (BiPAP). A step-wise multiple regression analysis was performed with the occurrence rate of inspiration after swallows as the dependent variable and various correlated variables as the independent variables.
  
  
  
  In both subject groups, the occurrence rate of inspiration after swallow was greater with BiPAP compared with control and CPAP conditions. Repetitive saliva swallowing test count and swallow non-inspiratory flow occurrence rate were extracted as predictor variables for risk of inspiration after swallows during BiPAP treatment.
  
  
  
  We found that the occurrence rate of inspiration after swallow is increased with BiPAP use irrespective of age. The results suggest that swallow non-inspiratory flow may trigger inspiratory support in the BiPAP mode, resulting in a risk of aspiration.
authors.affiliation: Department of Physical Therapy, Osaka Yukioka College of Health Science, Ibaragi, Japan.|Department of Rehabilitation, Hoshigaoka Medical Center, Hirakata, Japan.|Department of Physiology, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Hori
authors.affiliation: Department of Physical Therapy, Osaka Yukioka College of Health Science, Ibaragi, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Isaka
authors.affiliation: Department of Rehabilitation, Hoshigaoka Medical Center, Hirakata, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Oonishi
authors.affiliation: Murata Manufacturing Co., Ltd., Nagaokakyo, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Yabe
authors.affiliation: Department of Physiology, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Oku
mesh_terms: D000328:Adult; D000368:Aged; D003679:Deglutition / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000379:methods; D053120:Respiratory Aspiration / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D012143:Respiratory Physiological Phenomena; D018570:Risk Assessment / Q000379:methods; D013997:Time Factors; D014838:Volunteers
keywords: non-invasive positive pressure ventilation; respiration; swallowing