Faculty Collaboration Database

The effect of body position on esophageal reflexes in cats: a possible mechanism of SIDS? Pediatr Res 2018 Mar;83(3):731-738

Date

11/23/2017

Pubmed ID

29166377

Pubmed Central ID

PMC5902647

DOI

10.1038/pr.2017.302

Scopus ID

2-s2.0-85045558304 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

BackgroundIt has been hypothesized that life-threatening events are caused by supraesophageal reflux (SER) of gastric contents that activates laryngeal chemoreflex-stimulated apnea. Placing infants supine decreases the risk of sudden infant death syndrome (SIDS). The aim of this study was to determine whether body position affects esophageal reflexes that control SER.MethodsWe instrumented the pharyngeal and esophageal muscles of decerebrate cats (N=14) to record EMG or manometry, and investigated the effects of body position on the esophago-upper esophageal sphincter (UES) contractile reflex (EUCR), esophago-UES relaxation reflex (EURR), esophagus-stimulated pharyngeal swallow response (EPSR), secondary peristalsis (SP), and pharyngeal swallow (PS). EPSR, EUCR, and SP were activated by balloon distension, EURR by air pulse, and PS by nasopharyngeal water injection. The esophagus was stimulated in the cervical, proximal thoracic, and distal thoracic regions. The threshold stimulus for activation of EUCR, EURR, and PS, and the chance of activation of EPSR and SP were quantified.ResultsWe found that only EPSR was significantly more sensitive in the supine vs. prone position regardless of the stimulus or the position of the stimulus in the esophagus.ConclusionWe hypothesize that the EPSR may contribute to the protection of infants from SIDS by placement in the supine position.

Author List

Lang IM, Medda BK, Shaker R, Jadcherla S

Authors

Ivan M. Lang DVM, PhD Adjunct Professor in the Medicine department at Medical College of Wisconsin
Bidyut K. Medda PhD Associate Professor in the Medicine department at Medical College of Wisconsin
Reza Shaker MD Assoc Provost, Sr Assoc Dean, Ctr Dir, Chief, Prof in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Animals
Cats
Disease Models, Animal
Electromyography
Esophageal Sphincter, Upper
Esophagus
Humans
Infant
Manometry
Muscle Contraction
Patient Positioning
Peristalsis
Reflex
Sudden Infant Death
Supine Position