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J Appl Physiol (June 23, 2005). doi:10.1152/japplphysiol.00464.2005
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Submitted on April 22, 2005
Accepted on June 22, 2005

Effect of nasal continuous or intermittent positive airway pressure on non-nutritive swallowing in the newborn lamb

Nathalie Samson1, Marie St-Hilaire1, Elise Nsegbe1, Philippe Reix1, Francois Moreau-Bussiere1, and Jean-Paul Praud1*

1 Department of Pediatrics and Physiology, University of Sherbrooke, Sherbrooke, QC, Canada; Department of Pediatrics, University of Lyon, Lyon, France

* To whom correspondence should be addressed. E-mail: Jean-Paul.Praud{at}USherbrooke.ca.

The present study was aimed at investigating the effects of nasal continuous positive airway pressure (nCPAP, 6 cm H2O) or intermittent positive pressure ventilation (nIPPV, 10/4 cm H2O) on non-nutritive swallowing (NNS) and on the coordination between NNS and phases of the respiratory cycle, while taking into account the potential effects of states of alertness. Twelve full-term lambs were chronically instrumented at 48h after birth for polysomnographic recordings, including NNS, diaphragm electromyographic activity, respiratory movements, pulse oximetry and states of alertness. Studies in control conditions, with nCPAP and nIPPV were performed in random order in non sedated lambs at 4, 5 and 6 days of life. Results demonstrate that nCPAP significantly decreased overall NNS frequency, more specifically isolated NNS during quiet sleep and bursts of NNS in active sleep. In comparison, the effects of nIPPV on NNS frequency were more variable, with an inhibition of NNS only in wakefulness, and an increase in isolated NNS frequency in active sleep. In addition, neither nCPAP nor nIPPV disrupted the coordination between non-nutritive swallowing and phases of the respiratory cycle. In conclusion, nCPAP inhibits NNS occurrence in newborn lambs. Clinical relevance of this novel finding is related to the importance of NNS for clearing the upper airways from secretions and gastric content frequently regurgitated in the neonatal period.




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