Abstract：
OBJECTIVE: To examine the biomarkers of pharyngoesophageal swallowing during oral feeding sessions in infants undergoing pH-impedance testing and determine if swallow frequencies are distinct between oral- and partially oral-fed infants.
METHODS: One oral feeding session was performed in 40 infants during pH-impedance studies and measurements included swallowing frequency, multiple swallow rate, air and liquid swallow rates, esophageal swallow clearance time (ESCT), and gastroesophageal reflux (GER) characteristics. Linear and mixed statistical models were applied to examine the swallowing markers and outcomes.
RESULTS: Infants (30.2 ± 4.4 weeks birth gestation) were evaluated at 41.2 ± 0.4 weeks postmenstrual age (PMA). Overall, 10,675 swallows were analyzed during the oral feeding sessions (19.3 ± 5.4 min per infant) and GER events were noted (2.5 ± 0.3 per study). Twenty-four-hour acid reflux index (ARI) was 9.5 ± 2.0%. Differences were noted in oral- and partially oral-fed infants for: volume consumption (p<0.01), consumption rate (p<0.01), and length of hospital stay in days (p<0.01). Infants with ARI >7% had greater frequency of swallows (p=0.01). The oral-fed group had greater ARI (12.7 ± 3.3%, p=0.05).
CONCLUSIONS: Oropharyngeal swallowing regulatory characteristics decrease over the feeding duration and were different between ARI >7% vs ≤7%. Although GER is less in infants who are partially oral-fed, the neonates with increased acid exposure achieved greater oral intakes and shorter hospitalizations, despite the presence of comorbidities. Pharyngoesophageal stimulation as during consistent feeding or GER events can activate peristaltic responses and rhythms, which may be contributory to the findings.
METHODS: One oral feeding session was performed in 40 infants during pH-impedance studies and measurements included swallowing frequency, multiple swallow rate, air and liquid swallow rates, esophageal swallow clearance time (ESCT), and gastroesophageal reflux (GER) characteristics. Linear and mixed statistical models were applied to examine the swallowing markers and outcomes.
RESULTS: Infants (30.2 ± 4.4 weeks birth gestation) were evaluated at 41.2 ± 0.4 weeks postmenstrual age (PMA). Overall, 10,675 swallows were analyzed during the oral feeding sessions (19.3 ± 5.4 min per infant) and GER events were noted (2.5 ± 0.3 per study). Twenty-four-hour acid reflux index (ARI) was 9.5 ± 2.0%. Differences were noted in oral- and partially oral-fed infants for: volume consumption (p<0.01), consumption rate (p<0.01), and length of hospital stay in days (p<0.01). Infants with ARI >7% had greater frequency of swallows (p=0.01). The oral-fed group had greater ARI (12.7 ± 3.3%, p=0.05).
CONCLUSIONS: Oropharyngeal swallowing regulatory characteristics decrease over the feeding duration and were different between ARI >7% vs ≤7%. Although GER is less in infants who are partially oral-fed, the neonates with increased acid exposure achieved greater oral intakes and shorter hospitalizations, despite the presence of comorbidities. Pharyngoesophageal stimulation as during consistent feeding or GER events can activate peristaltic responses and rhythms, which may be contributory to the findings.
摘要：
目的：在接受pH-阻抗测试的婴儿口服喂养期间检查咽食管吞咽的生物标志物，并确定口服和部分口服喂养的婴儿的吞咽频率是否不同。
方法：在pH-阻抗研究期间，对40名婴儿进行了一次口服喂养，测量包括吞咽频率，多次吞咽率，空气和液体吞咽率，食道吞咽清除时间（ESCT），胃食管反流(GER)特点。应用线性和混合统计模型来检查吞咽标记和结果。
结果：在月经后41.2±0.4周（PMA）评估婴儿（30.2±4.4周出生妊娠）。总的来说,在口服喂养期间分析了10,675只吞咽（每个婴儿19.3±5.4分钟），并记录了GER事件（每个研究2.5±0.3）。24小时酸回流指数（ARI）为9.5±2.0％。在口服和部分口服喂养的婴儿中注意到差异：体积消耗（p<0.01），消耗率(p<0.01)，住院天数(p<0.01)。ARI>7％的婴儿吞咽频率更高（p=0.01）。口服组ARI较高(12.7±3.3%,p=0.05)。
结论：口咽吞咽的调节特征在进食时间内降低，ARI>7%与≤7%之间存在差异。尽管部分口服喂养的婴儿的GER较少，酸暴露增加的新生儿获得了更多的口腔摄入量和更短的住院时间，尽管存在合并症。持续进食或GER事件期间的咽食管刺激可激活蠕动反应和节律，这可能是对调查结果的贡献。
方法：在pH-阻抗研究期间，对40名婴儿进行了一次口服喂养，测量包括吞咽频率，多次吞咽率，空气和液体吞咽率，食道吞咽清除时间（ESCT），胃食管反流(GER)特点。应用线性和混合统计模型来检查吞咽标记和结果。
结果：在月经后41.2±0.4周（PMA）评估婴儿（30.2±4.4周出生妊娠）。总的来说,在口服喂养期间分析了10,675只吞咽（每个婴儿19.3±5.4分钟），并记录了GER事件（每个研究2.5±0.3）。24小时酸回流指数（ARI）为9.5±2.0％。在口服和部分口服喂养的婴儿中注意到差异：体积消耗（p<0.01），消耗率(p<0.01)，住院天数(p<0.01)。ARI>7％的婴儿吞咽频率更高（p=0.01）。口服组ARI较高(12.7±3.3%,p=0.05)。
结论：口咽吞咽的调节特征在进食时间内降低，ARI>7%与≤7%之间存在差异。尽管部分口服喂养的婴儿的GER较少，酸暴露增加的新生儿获得了更多的口腔摄入量和更短的住院时间，尽管存在合并症。持续进食或GER事件期间的咽食管刺激可激活蠕动反应和节律，这可能是对调查结果的贡献。
