You are here

Article Text

Article menu

Download PDFPDF

XML
Chronic obstructive pulmonary disease
Breathing–swallowing discoordination is associated with frequent exacerbations of COPD
  1. Shinsuke Nagami1,2,3,
  2. Yoshitaka Oku2,4,
  3. Naomi Yagi3,4,
  4. Susumu Sato5,
  5. Ryuji Uozumi6,
  6. Satoshi Morita6,
  7. Yoshie Yamagata7,
  8. Jun Kayashita7,
  9. Kazuya Tanimura5,8,
  10. Atsuyasu Sato5,
  11. Ryosuke Takahashi1 and
  12. Shigeo Muro5
  1. 1 Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  2. 2 Department of Physiology, Hyogo College of Medicine, Nishinomiya, Japan
  3. 3 Clinical Research Center for Medical Equipment Development (CRCMeD), Kyoto University Hospital, Kyoto, Japan
  4. 4 Department of Swallowing Physiology, Hyogo College of Medicine, Nishinomiya, Japan
  5. 5 Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  6. 6 Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  7. 7 Department of Health Sciences, Prefectural University Hiroshima, Hiroshima, Japan
  8. 8 Department of Respiratory Medicine, Chest Disease Clinical and Research Institute, Kishiwada City Hospital, Kishiwada, Japan
  1. Correspondence to Dr Shigeo Muro; smuro{at}kuhp.kyoto-u.ac.jp

Abstract

Introduction Impaired coordination between breathing and swallowing (breathing–swallowing discoordination) may be a significant risk factor for the exacerbation of chronic obstructive pulmonary disease (COPD). We examined breathing–swallowing discoordination in patients with COPD using a non-invasive and quantitative technique and determined its association with COPD exacerbation.

Methods We recruited 65 stable outpatients with COPD who were enrolled in our prospective observational cohort study and did not manifest an apparent swallowing disorder. COPD exacerbation was monitored for 1 year before and 1 year after recruitment. Swallowing during inspiration (the I-SW pattern) and swallowing immediately followed by inspiration (the SW-I pattern) were identified.

Results The mean frequency of the I-SW and/or SW-I patterns (I-SW/SW-I rate) was 21.5%±25.5%. During the 2-year observation period, 48 exacerbation incidents (25 patients) were identified. The I-SW/SW-I rate was significantly associated with the frequency of exacerbation. During the year following recruitment, patients with a higher I-SW/SW-I frequency using thicker test foods exhibited a significantly higher probability of future exacerbations (p=0.002, log-rank test).

Conclusions Breathing–swallowing discoordination is strongly associated with frequent exacerbations of COPD. Strategies that identify and improve breathing–swallowing coordination may be a new therapeutic treatment for patients with COPD.

  • COPD Exacerbations
  • Respiratory Measurement
  • Lung Physiology

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjresp-2017-000202

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors SN contributed to the protocol design, data collection and analysis and writing of the manuscript. YO contributed to the protocol design, data analysis and writing of the manuscript. NY contributed to the data analysis and the review of the manuscript. SS contributed to the protocol design, data collection and analysis and editing of the manuscript. RU contributed to the data analysis and review of the manuscript. SMO contributed to the data analysis and review of the manuscript. YY contributed to the data analysis and review of the manuscript. JK contributed to the data analysis and review of the manuscript. KT contributed to the data analysis and review of the manuscript. RT contributed to the data analysis and supervised the study. SMU contributed to the protocol design, data collection and analysis and writing of the manuscript.

    • Funding YO, NY and SN received financial support from FoodCare and CareIdo. Swallowing monitors and sensors were provided by Murata Manufacturing. This work was supported by grants from JSPS KAKENHI: NumbersJP16K01546 and JP16K16264.

    • Patient consent Obtained.

    • Ethics approval The study was approved by the institutional ethics committee of the Kyoto University (approval number, C841).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Indigenous protocols may limit the sharing of data for this paper.