Journal Article Breathing–swallowing discoordination is associated with frequent exacerbations of COPD

Nagami, Shinsuke  ,  Oku, Yoshitaka  ,  Yagi, Naomi  ,  Sato, Susumu  ,  Uozumi, Ryuji  ,  Morita, Satoshi  ,  Yamagata, Yoshie  ,  Kayashita, Jun  ,  Tanimura, Kazuya  ,  Sato, Atsuyasu  ,  Takahashi, Ryosuke  ,  Muro, Shigeo

4 ( 1 ) 2017-06-01 , BMJ Publishing Group
[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 noninvasive 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.

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