RELATIONSHIP BETWEEN THE PHASES OF THE SWALLOWING PROCESS IN PRETERM NEWBORNS

Abstract

INTRODUCTION: The phases of the swallowing process (oral preparatory, oral, pharyngeal and esophageal) have been described in numerous national and international publications. The interactions between these phases and the impact of one over the other have been shown clinically through videofluoroscopic swallow study (VFSS). In this research we will study the mechanism of swallowing in preterm newborns (PTNB, PT = 25 to 37wks GE) at the beginning of the nutritive sucking.

AIM: Analyze the relationship of the different phases of the swallowing process in the PTNB. In particular, analyze the pharyngeal activity according to the preparation of the sucking and the sucking-swallowing-respiration mechanism.

METHOD: 81 RNPT were studied through a perceptual-visual method. With the informed consent of the parents, VFCD study was carried out by medical indication. Clinical signs were monitored through oxygen saturometry; identified the performance of the mechanism of swallowing in its four phases; and the causes of the alteration have also been informed.

RESULTS: The first 3 phases of the swallowing process were evaluated. Chi-square tests were carried out to analyze the independence between the different phases of the swallowing process, resulting significant in pairs in all the tests, indicating that there is no independence between the different phases. Then a logistic regression model with pharyngeal activity was applied as response variable, and sucking preparation and sucking-swallowing-respiration mechanism as variables, the latter being significant.

CONCLUSIONS: In the first study the dependence of the different phases on each other is observed, verifying the contribution of the published literature on the valve system and how one phase impacts on another in the framework of synchronism and the coordination of all the mechanism of swallowing. With respect to the second study, it can be seen that the impact on pharyngeal activity is greater with the immediately preceding phase, the sucking-swallowing-respiration mechanism.