Effects of Birth Asphyxia on the Modulation of Pharyngeal Provocation Induced Adaptive Reflexes

American Journal of Physiology. Gastrointestinal and Liver Physiology
Ish K GulatiSudarshan R Jadcherla


Perinatal asphyxia and aerodigestive symptoms are troublesome. We tested the hypothesis that pharyngeal provocation alters proximal and distal aerodigestive reflex coordination and kinetics in infants with hypoxic ischemic encephalopathy (HIE), compared with healthy controls. Specifically, we characterized the sensory-motor properties of pharyngeal provocation induced effects on upper esophageal sphincter (UES) and lower esophageal sphincter (LES) reflexes. Ten orally-fed controls (32.0 ± 1.5 weeks gestation) and 25 infants with HIE (38.1 ± 0.4 weeks gestation), were evaluated at 39.7 ± 0.9 weeks and 41.9 ± 0.6 weeks postmenstrual age respectively. Pharyngo-esophageal reflexes evoked upon graded water stimuli were tested using water-perfusion micromanometry methods. Analysis included sensory-motor characteristics of pharyngeal reflexive swallow (PRS), pharyngo-UES- contractile reflex (PUCR), esophageal body-waveform kinetics, and pharyngo-LES-relaxation reflex (PLESRR). For controls vs. infants with HIE, median APGAR scores were 6 vs. 1 at 1 min (P< 0.001), and 8 vs. 3 at 5 min (P< 0.001). Upon pharyngeal- stimulation, HIE infants (vs. controls) had frequent PUCR (P= 0.01); increased UES basal tone (P= 0.03); decreased LES basa...Continue Reading


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